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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434416046
Report Date: 05/02/2024
Date Signed: 05/02/2024 03:33:28 PM

Document Has Been Signed on 05/02/2024 03:33 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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:BARRERA, MILTONFACILITY NUMBER:
434416046
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 6CENSUS: 5DATE:
05/02/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:45 PM
MET WITH:Milton BarreraTIME VISIT/
INSPECTION COMPLETED:
03:45 PM
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Licensing Program Analyst (LPA) Deanna Villagrana met with licensee Milton Barrera for a case management visit. Licensee is requesting and increase of capacity. Present were license, licensee's assistant Irene Ramos and five day care children including two infants.

LPA toured the indoor and outdoor areas of the home during today’s inspection. LPA observed that the home is clean and orderly, with heating and ventilation for safety and comfort of the children. LPA observed barricaded stairs in the home. LPA observed safe and sufficient materials, toys, and play equipment for the day care children. All sharp objects, detergents, cleaning compounds, medications, poisons, and other similar items inside the home are stored inaccessible to children. Off limit areas indoor: master bedroom with a bath, two bedrooms, one bathroom and downstairs attached garage. LPA observed the back yard is fenced and there are no bodies of water. Off limits outdoor: right and back side of home that is fenced off to children and a locked storage. Licensee states there are no fire arms/weapons or animals in the home.

LPA reviewed file for assistant Irene Ramos and observed file is complete. Irene has a current First Aid and CPR certification expiring 06/04/2024 and completed Mandated Reporter training on 09/16/2022. A fire clearance was received on 04/24/2024 and approved on 04/22/2024 by San Jose Fire Department. LPA informed licensee a large Family Home Day Care licensee is approved pending manager's approval.

No deficiency was cited.

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.

SUPERVISORS NAME: Susy Cervantes
LICENSING EVALUATOR NAME: Deanna Villagrana
LICENSING EVALUATOR SIGNATURE: DATE: 05/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/02/2024
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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