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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434415777
Report Date: 06/18/2024
Date Signed: 06/19/2024 08:22:10 AM

Document Has Been Signed on 06/19/2024 08:22 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:WALKER, ELAINEFACILITY NUMBER:
434415777
ADMINISTRATOR/
DIRECTOR:
WALKER, ELAINEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 836-4293
CITY:SAN JOSESTATE: CAZIP CODE:
95148
CAPACITY: 14TOTAL ENROLLED CHILDREN: 11CENSUS: 6DATE:
06/18/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:45 AM
MET WITH:Elaine WalkerTIME VISIT/
INSPECTION COMPLETED:
12:10 PM
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On 06/18/2024 at 8:45am, Licensing Program Analyst (LPA), Farida Raja, conducted an unannounced annual/random inspection. LPA was granted access to the home by Assistant, Patrice Duncan and explained the nature of today’s inspection. Present in the home were licensee, two assistants and 6 children (one school age, 4 preschoolers, and one infant). Licensee was operating within the ratio and capacity requirements of the license. Days and hours of operation are Monday to Friday, 7:00 am to 5:30 pm. LPA observed all required posted materials in the garage area of the home. The adults that reside in the home are licensee and daughter. There are no minor children residing in the home. The home is single story with four bedrooms and two bathrooms. Licensee submitted an updated Application For a Family Child Home License (LIC 279) and an updated Emergency Disaster Plan for Family Child Care Homes (LIC 610A) during today's inspection. Left side gate is used by parents to drop off and pick up daycare children.

LPA toured the indoor and outdoor areas of the home during today's inspection. Licensee has a working telephone in the home (408-836-4293). LPA observed sufficient materials, toys, and play equipment for the day care children. Furniture including shelves, are in good condition. The floors were free of tripping hazards with toys put away on shelves. The home has central heating/cooling and ventilation for comfort of children. LPA did not observe stairs in areas on limit to children. Licensee stated that on limit areas for children include the converted garage and one bathroom. Off limit areas inside the home include the master bedroom, master bathroom, three bedrooms and locked closet in the garage area. LPA observed a fish tank in the on limit garage. Licensee has one pet dog. Off limit areas outside the home: right side gated section and fenced and gated garden area. Backyard is fenced and both sides of the home are gated. The outdoor space and play equipment were observed to be age appropriate. LPA reminded licensee that all children's toys and play structures need to be maintained in good repair prior to allowing access to children.

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SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Farida Raja
LICENSING EVALUATOR SIGNATURE: DATE: 06/18/0202
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/18/2024
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
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: WALKER, ELAINE
FACILITY NUMBER: 434415777
VISIT DATE: 06/18/2024
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There are no bodies of water observed. LPA observed that the bathroom used by children was in operating condition. Toilets and faucet are clean and operable. LPA observed child proof locks on cabinets under bathroom sink to secure items that are to be inaccessible to children. The shower area is free of any hazards.
LPA observed a fully charged 2A10BC fire extinguisher in the garage area and working smoke/carbon monoxide detector. Licensee states that she does not have any weapons in the home. All detergents, cleaning compounds, poisons, medications, sharp objects and other similar items were observed to be stored inaccessible to children. Licensee understands that smoking is prohibited in the home.

Drinking water is readily available for children indoors and outdoors via water pitcher and disposable cups. Licensee states that she provides breakfast, lunch and snacks to the children in care and LPA observed a posted menu. Licensee understands that any food brought from home shall be labeled with each child's name and properly stored or refrigerated. Licensee states that a child will be isolated in the hallway to the home if necessary due to illness or communicable disease until parent pick up.

Children file review was completed and found to be current and up to date. Six (6) children’s files were reviewed during today's inspection. Licensee carries daycare insurance through Markel Insurance Company and LPA observed a current policy verifying valid coverage. LPA reviewed one infant's file and the file was complete with the required forms, including log of 15 minute nap checks.

LPA discussed the safe sleep regulations with licensee 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 licensee 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 reviewed three (3) staff files (Licensee and two adult assistants) for the required forms. All individuals have clearances for Tuberculosis, Criminal Background, and Child Abuse Index Checks.

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SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Farida Raja
LICENSING EVALUATOR SIGNATURE:

DATE: 06/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2024
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
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: WALKER, ELAINE
FACILITY NUMBER: 434415777
VISIT DATE: 06/18/2024
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Licensee's Pediatric CPR/First Aid certification expires on 06/01/2025. Licensee and one staff (S3) stated that they have obtained the immunization for measles but did not have proof of vaccination. LPA informed licensee to either obtain a statement from physician stating immunity to measles or obtain the immunization and maintain proof in their file. Licensee and staff are current with Mandated Reporter Training for Child Care Workers. Licensee's Mandated Reporter Training expires on 10/09/2025. Licensee understands the training is mandatory to all Licensees and adults in the home in contact will children and requires renewal every two years

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Supervision of children was discussed with Licensee, and she understands that she or a qualified adult must be present in the home during day care hours and ensure that the children are supervised at all times. LPA discussed the requirement for Licensee to be present at the facility 80 percent of the hours the facility is in operation and that temporary absences shall not exceed 20 percent of the hours that the facility is providing care per day. Licensee understands her capacity options and she understands that she cannot have more than 14 children in the home at any time and a qualified assistant must be present. Licensee understands in absence of a helper her license capacity is reduced to 8 and ratio (age of the children) must be observed.

LPA discussed "zero tolerance" related regulations which includes the assessment of an immediate $500 per day civil penalty for any violation of a "zero tolerance" related regulation. A $500 immediate civil penalty is assessed for serious violations such as absence of supervision, accessible bodies of water, accessible firearms, refused entry of licensing staff, presence of an excluded person, and violations that result in illness or injury. An ongoing civil penalty of $100 per day continues until the violation(s) is corrected.

Licensee is encouraged to visit the Department’s website at https://cdss.ca.gov/inforesources/child-care-licensing to access general updates, resources for providers, regulations, adoptions of new laws, pay annual fees etc. The Department will communicate all new information to providers through Provider Information Notices (PINs). Please sign up to be notified for new PINs at www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and visit the Department’s website for the latest PINs.

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SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Farida Raja
LICENSING EVALUATOR SIGNATURE:

DATE: 06/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2024
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
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: WALKER, ELAINE
FACILITY NUMBER: 434415777
VISIT DATE: 06/18/2024
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This facility provides Incidental Medical Services – IMS for one child in care. LPA reviewed storage of medication (epinephrine auto injector and inhaler) and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see PIN 22-02-CCP. LPA provided Licensee with a copy of PIN 22-02-CCP and licensee will submit an Incidental Medical Plan to LPA by 02/07/2024. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514- 0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

Licensee states that she does not transport any day care children. LPA reminded Licensee that if she decides to transport children, children should not be left unattended in parked vehicles and that car seats shall only be used for transportation and shall not be used for sleeping.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California. During the exit interview, licensee confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

One Technical Violation was cited as a result of today's inspection. Exit interview conducted and report was reviewed with the licensee, Elaine Walker.

A NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 DAYS.
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Farida Raja
LICENSING EVALUATOR SIGNATURE:

DATE: 06/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2024
LIC809 (FAS) - (06/04)
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