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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434416214
Report Date: 09/08/2022
Date Signed: 09/08/2022 03:21:13 PM

Document Has Been Signed on 09/08/2022 03:21 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-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:PEREZ, VONITAFACILITY NUMBER:
434416214
ADMINISTRATOR:VONITA PEREZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
4082309274
CITY:SAN JOSESTATE: CAZIP CODE:
95133
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 3DATE:
09/08/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:28 AM
MET WITH:Perez Vonita TIME COMPLETED:
02:30 PM
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On 09/08/2022 Licensing Program Analysts (LPA) Stephanie Collins conducted an annual inspection. LPA met with Licensee Vonta Perez and explained the nature of today's inspection. Present during the inspection were the Licensee and three children (one infant and two preschooler ) in care. Hours of operation are 7:30 AM and 5:30 PM. Adults residing in the home are the Licensee and Noah Baptiste. A review of records on 9/7/2022 shows that individuals who require caregiver background checks have received criminal record and child abuse index clearances or

Licensee Vonita Perez was reminded that all adults 18 and over living or working in the home, 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 licensed Family Child Care Home. 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.

Licensee has CPR and First Aid, which has an expiration date of 1/2023. LPA observed the Licensee has proof of immunity against Measles the Licensee has opted out of the flu vaccine. During file review LPA observed licensee has proof of immunity against Tuberculosis (TB) clearances on file., Mandated Reporter Training completed 5/15/2021 and Preventive Health and Safety Training.
LPA conducted a file review of records required to be available during an inspection:
Home has a current roster of the children, the home conducted fire and disaster drill on
6/ 9/2022. Licensee Vonita understand fire and disaster drills are required to be conducted every six months with documented dates and times of each drill. Licensee showed proof of immunization's for children and maintains updated records for children in care. Licensee provides the child’s parent or representative with a copy of the Family Child Care Home Notification of Parents’ Rights.

The licensee is present in the home and ensures that children in care are supervised at all times. The licensee is observed as maintaining capacity as specified on the license.
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Stephanie Collins
LICENSING EVALUATOR SIGNATURE: DATE: 09/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/08/2022
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
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: PEREZ, VONITA
FACILITY NUMBER: 434416214
VISIT DATE: 09/08/2022
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LPA inspected the indoor and outdoor areas of the home. Smoke and Carbon monoxide detectors were tested and proved to be none functioning. LPA observed a functioning fire extinguisher and Pull Station. Fireplaces and open face heaters are screened to prevent access by children. Off limit areas in the home are as follows: All bedrooms kitchen and garage. Storage areas for poisons, detergents ,cleaning compounds, medication and other items which could pose a danger to children are stored where they are inaccessible to children. The home is kept clean and orderly, with heating and ventilation for safety and comfort. The home provides safe toys, play equipment and materials. Licensee state there are No weapons or ammunition housed on the premises.
Outside patio backyard area is open for outside actives and fully fenced in. No bodies of water observed.
LPA reviewed with Vonita Perez -licensee, the LIC 311D, Forms/Records To Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.

To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

LPA discussed the safe sleep regulations with licensee Vonita Perez and discussed the Child Care Licensing Safe Sleep web page at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee Vonita Perez 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.

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Stephanie Collins
LICENSING EVALUATOR SIGNATURE:

DATE: 09/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/08/2022
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: PEREZ, VONITA
FACILITY NUMBER: 434416214
VISIT DATE: 09/08/2022
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To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process

Notice of Site Visit

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

Exit Interview

Exit interview conducted and report was reviewed with the licensee Vonita Perez

This report was generated in the San Jose Regional Office due the printer malfunction.

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Stephanie Collins
LICENSING EVALUATOR SIGNATURE:

DATE: 09/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/08/2022
LIC809 (FAS) - (06/04)
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