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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434416229
Report Date: 10/01/2024
Date Signed: 10/01/2024 05:55:48 PM

Document Has Been Signed on 10/01/2024 05:55 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:TAN, CHUNHUIFACILITY NUMBER:
434416229
ADMINISTRATOR/
DIRECTOR:		CHUNHUI TANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 828-8020
CITY:SAN JOSESTATE: CAZIP CODE:
95148
CAPACITY: 14TOTAL ENROLLED CHILDREN: 12CENSUS: 11DATE:
10/01/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:50 AM
MET WITH:Chunhui TanTIME VISIT/
INSPECTION COMPLETED:
11:50 AM
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On 10/01/2024 at 8:50am, Licensing Program Analysts (LPAs), Farida Raja and Linke 'Kate' Huang conducted an unannounced annual/random inspection. LPAs were granted access to the home by Licensee, Chunhui (Sierra) Tan, and explained the nature of today’s inspection. Present in the home were licensee, two assistants and eleven children including two infants and nine preschool children. Licensee was operating within the ratio and capacity requirements of the license. Days and hours of operation are Monday to Friday, 8:30 am to 5:30 pm. LPAs observed all required posted materials near the front entrance to the home. The adults that reside in the home are licensee and spouse. Licensee has one minor child residing in the home. Licensee submitted an updated Application for a Family Child Home License during today's inspection.

LPAs toured the indoor and outdoor areas of the home. Children were having snack and engaged in free play during today's inspection. Licensee has a working telephone in the home. LPAs observed sufficient books, materials, toys, and play equipment for the day care children. Furniture, such as tables, chairs and shelves, are in good condition. The home has central heating/cooling and ventilation for comfort of children. The home is single story. Off limit areas inside the home: master bedroom, master bathroom, two bedrooms, gated kitchen, storage room, closets and attached garage. Off limit areas outside the home: gated left and right side sections. Backyard is fenced and both sides of the home are gated. The outdoor space and play equipment were observed to be age appropriate and free of hazards. Shade is provided with canopies. There were no bodies of water observed. LPAs observed that the bathroom used by children was in operating condition. Toilets and faucet are clean and operable. The shower area is free of any hazards.

LPAs observed a fully charged 2A10BC fire extinguisher near the front entrance and working smoke/carbon monoxide detectors. LPAs reminded licensee that the fire extinguisher needs to be serviced once every 12 months. Licensee states that she does not have any weapons or pets 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.

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SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Farida Raja
LICENSING EVALUATOR SIGNATURE: DATE: 10/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/01/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 4
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: TAN, CHUNHUI
FACILITY NUMBER: 434416229
VISIT DATE: 10/01/2024
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Drinking water is readily available for children in the home via individual water bottles. Licensee states that she provides lunch and snacks to the children in care. Licensee understands that any food brought from home shall be labeled with each child's name and properly stored or refrigerated. Licensee participates in a Food Program. Licensee states that a child will be isolated in the playroom away from other children if necessary due to illness or communicable disease.

LPAs reviewed a current facility roster and fire/disaster drill log during today's inspection. Fire/disaster drill was last conducted on 04/24/2024. LPAs obtained copy of children's roster.

Children file review was completed and found to be current and up to date. Seven (7) children’s files were reviewed during today's inspection. Licensee carries daycare insurance and LPAs observed a current policy verifying valid coverage. LPAs reviewed one infant's file and observed 15 minute nap checks documented..

LPAs 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. LPAs 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.

LPAs reviewed three (3) staff files (Licensee and two assistant's) for the required forms and found them to be current and up to date. A review of staff records indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. Licensee has current Pediatric CPR/First Aid certification which expires on 08/11/2026. Licensee and staff have the required immunization in file for measles, pertussis and influenza. Licensee and two assistants have current Mandated Reporter Training's for Child Care Workers. Licensee understands the training is mandatory to all Licensee and adults in the home in contact will children and requires renewal every two years.

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

DATE: 10/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/01/2024
LIC809 (FAS) - (06/04)
Page: 2 of 4
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: TAN, CHUNHUI
FACILITY NUMBER: 434416229
VISIT DATE: 10/01/2024
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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.

Licensee was encouraged to frequently visit the department website at www.ccld.ca.gov for licensing updates, provider information notices (PINs) and regulations.

Incidental Medical Services (IMS) policy was discussed. Licensee states that she is not administering any medications or IMS to children at this time. For IMS information see PIN 22-02-CCP. LPA provided Licensee with a copy of PIN 22-02-CCP during today's inspection. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/.

Licensee states that she does not transport any day care children. LPAs 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.

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

DATE: 10/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/01/2024
LIC809 (FAS) - (06/04)
Page: 3 of 4
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: TAN, CHUNHUI
FACILITY NUMBER: 434416229
VISIT DATE: 10/01/2024
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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.

As a result of today's inspection, there were no deficiencies cited. Exit interview conducted and report was reviewed with the licensee, Chunhui 'Sierra' Tan.

A NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 DAYS.

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.

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

DATE: 10/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/01/2024
LIC809 (FAS) - (06/04)
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