434416251-1-25-2023-07-CC-SCOS-CNEQYC-20230125113456

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434416251
Report Date: 01/25/2023
Date Signed: 01/25/2023 11:35:05 AM

Document Has Been Signed on 01/25/2023 11:35 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:	RAYA, TIFFANY		FACILITY NUMBER:	434416251
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 4	DATE:	01/25/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Tiffany Raya		TIME COMPLETED:	11:50 AM

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	Page 1 Licensing Program Analysts (LPA) , Stephanie Collins, and conducted an unannounced Annual inspection of the Family Child Care Home (FCCH) . LPA met with Licensee Raya Tiffany and informed her the purpose of the visit “Annual Inspection” and the Licensee has requested. A Change of Capacity to the current license: Licensee Tiffany Raya has been licensed as small FCCH since 1/16/2022, Therefore, demonstrating compliance with regulation with at least one year of experience as a regulated small family childcare home operator. LPA arrived at facility at 8:35 A M. There were (4) four children in attendance during the inspection. Adults Present during the inspection were the licensee and her assistant Esmeralda Romo. All adults present during inspection have obtained and cleared their criminal record back-ground checks. Licensee 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. All required documents to be posted in a prominent publicly accessible area in the Family Child Care Home were observed to be posted. Operating days and hours are Monday -Friday 07:00 AM to 06:00 PM.

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Stephanie Collins
LICENSING EVALUATOR SIGNATURE:	DATE: 01/25/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/25/2023

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 3

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: RAYA, TIFFANY	FACILITY NUMBER: 434416251
	VISIT DATE: 01/25/2023

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
26
27
28
29
30
31
32

Page 2
LPA inspected the home inside and out with Licensee Tiffany Raya. The home is a single level home. Primary Indoor activity area is in this the front living room and one bedroom is used for napping and/or quite time. The hall bathroom is utilized for the preschool children. Off limit areas in home are the two-back bedrooms, hall storage area, kitchen and garage. Outdoor activity space is in the front of home inside a fully fenced front yard area. Licensee is aware children are never be left alone during outdoor activity time and will always be supervised. Backyard is off limits. LPA observed play equipment were maintained in a good condition, free of hazards

No bodies of water observed during inspection. Licensee states there are no weapons on the premises. Fully charged fire extinguisher and carbon monoxide detectors observed and functioning

Floors were clean. Disinfectants, cleaning solutions, poisons, sharps, and other items that are dangerous to children were stored inaccessible. LPA observed that food storage areas were clean, free of litter, rubbish, and rodents/vermin. Foods and beverages were kept protected against contamination and spoilage. Trash cans for solid waste had tight-fitting covers on. Drinking water is arranged to be readily available to children.

Log recorded that the last fire/disaster drill was conducted on 8/16/2022.
Children file review was completed and found to be current and up to date. Staffs files review was completed and found to be current and up to date. Licensee CPR and First Aid Cert Exp. January 2024 and Mandated Reporter Cert. Exp. October 18. 2024

This facility provides Incidental Medical Services –Currently the facility does not have any children in care who requires IMS. 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: http://www.ada.gov/childqanda.htm.

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Stephanie Collins
LICENSING EVALUATOR SIGNATURE:	DATE: 01/25/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/25/2023

LIC809 (FAS) - (06/04)

Page: 2 of 3

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: RAYA, TIFFANY	FACILITY NUMBER: 434416251
	VISIT DATE: 01/25/2023

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
26
27
28
29
30
31
32

Page 3
Safe Sleep

LPA discussed the safe sleep regulations with licensee Tiffany Raya 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 [facility representative] 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 with Licensee Tiffany Raya the violations that would result in an immediate $500 civil penalty assessment. Director is encouraged to visit the Department’s website at www.cdss.ca.gov [Shortcut: ccld.ca.gov] to access resources for Providers, Regulations etc.

LPA discussed the capacity regulations for a Large family Child Care Home Capacity and reviewed capacity chart.

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.

In the areas that were evaluated, no regulatory violations were observed at the time of the inspection.

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

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Stephanie Collins
LICENSING EVALUATOR SIGNATURE:	DATE: 01/25/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/25/2023

LIC809 (FAS) - (06/04)

Page: 3 of 3