434415754-4-27-2022-07-CC-JGSS-CDVVXD-20220427164922

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434415754
Report Date: 04/27/2022
Date Signed: 04/27/2022 04:49:29 PM

Document Has Been Signed on 04/27/2022 04:49 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME:	MIMIZ DAYCARE CENTER		FACILITY NUMBER:	434415754
ADMINISTRATOR:	MARYAM YOOSEFI		FACILITY TYPE:	850
ADDRESS:	3225 S. WINCHESTER BOULEVARD		TELEPHONE:	(408) 482-6776
CITY:	CAMPBELL	STATE: CA	ZIP CODE:	95008
CAPACITY:	29	CENSUS: 23	DATE:	04/27/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Mahmood Ghasemian		TIME COMPLETED:	05:05 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analyst (LPA), James Santos conducted an unannounced Required 1 Year inspection visit today. LPA met with Director, Mahmood Ghasemian and discussed the purpose of the visit. LPA toured the center with the Director. LPA observed the required documents which includes the Facility License, Emergency Disaster Plan, Earthquake Preparedness Checklist, Parents' Rights Poster, Personal Rights, Child Car Seat Law, Food Menu, and Daily Activity Schedule are posted prominently on the walls. The Center's operation days and times are Monday through Friday from 8:00AM to 5:30PM. The classrooms were observed to be clean and in good order. Furniture and play equipment were observed to be age appropriate and in good condition. Children's restroom is clean and in good operating condition. Fire extinguishers and alarm, smoke and carbon monoxide detectors and first aid kit were observed throughout the inside area. Trash cans for solid wastes have tight-fitting covers on. Disinfectants, cleaning solutions and other chemical items and sharp objects are stored and inaccessible to children. Staff have separate lounge room and bathroom. Per Director, they do not have poisons, weapons and ammunition on the premises and they do not provide transportation to children. They also do not provide incident medical services. The center provides meals to the children. The kitchen and food preparation area is functional and has running water, sink, refrigerator and storage space for food. The outside area was inspected. The preschool playground area is surrounded by appropriate fencing and is separate from the infant playground area. The playground equipment are age appropriate. There are climbing structures and artificial grass with rubber padding used as resilient materials. Shade is provided by trees, canopies, and covered patio areas. There are adequate equipment, supplies, and toys for children outdoors. There are no bodies of water or hazards observed. Drinking water were observed to be available to children. Continued on next page

SUPERVISOR'S NAME: Joel Segura	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: James G Santos	TELEPHONE: (408) 334-8556
LICENSING EVALUATOR SIGNATURE:	DATE: 04/27/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/27/2022

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: MIMIZ DAYCARE CENTER	FACILITY NUMBER: 434415754
	VISIT DATE: 04/27/2022

NARRATIVE

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LPA reviewed children's files. Children's records reviewed include Admission Agreement, Identification and Emergency Contact, Consent for Emergency Medical Treatment form, receipt of Parent Rights Notice, Personal Rights Notice, Physician's Report and Immunization Record.

LPA reviewed staff files. Staff records reviewed include Criminal Record Clearance, Statement Acknowledging Requirement to report Child Abuse, Immunization Record, CPR/First Aid, Mandated Reported Training, Qualifications and Education. Per review of record, the center conducts emergency disaster drills at least twice a year.

Director was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with Director and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed Director of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

LPA advised Director to visit the Department’s website at www.cdss.ca.gov to access resources for Providers, Regulations, Online option to pay Annual License fee, Adoption of new Laws, etc.

As a result of this inspection, a deficiency has been cited. See LIC809D for deficiency. Appeal rights were reviewed and provided.

Exit interview conducted and report was reviewed with the Director. LPA advised Director of the required "mandated reporter" training for Assembly Bill, AB 1207 requirement for Child Care Providers that all staff must complete and renew every two (2) years. The website for the online training is: http://www.mandatedreporterca.com

A notice of site visit was given and must remain posted for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISOR'S NAME: Joel Segura	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: James G Santos	TELEPHONE: (408) 334-8556
LICENSING EVALUATOR SIGNATURE:	DATE: 04/27/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/27/2022

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 04/27/2022 04:49 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: MIMIZ DAYCARE CENTER	FACILITY NUMBER: 434415754
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 04/27/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care. Six (6) staff records reviewed showed their Mandated Reporter Training certifications have expired.
	POC Due Date: 05/27/2022
	Plan of Correction
1 2 3 4	Director stated they will complete the mandated reporter training for AB 1207 and submit proof of completion of training to CCL by POC due date of 5/27/2022.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Joel Segura	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: James G Santos	TELEPHONE: (408) 334-8556
LICENSING EVALUATOR SIGNATURE:	DATE: 04/27/2022

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/27/2022

LIC809 (FAS) - (06/04)

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