434416567-12-15-2023-07-CC-JBOT-CYJQ9N-20231215105837

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434416567
Report Date: 12/15/2023
Date Signed: 12/15/2023 11:00:05 AM

Document Has Been Signed on 12/15/2023 11:00 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 CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME:	FERKEL, BRANDON		FACILITY NUMBER:	434416567
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	12/15/2023
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Brandon Ferkel		TIME COMPLETED:	11:15 AM

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Licensing Program Analysts (LPAs) Jessica Bongardt and Mel Matos met with Brandon Ferkel, Applicant, and Bruna Correa De Araujo, Applicant's spouse, to conduct an announced Prelicensing inspection at 135 Rio Robles East Unit 162, San Jose, CA 95134. Note: the Applicant's home is located in The Laurel Apartments facing Baypointe Parkway. Public parking is available on the street and LPAs communicated with the Applicant via telephone to get access to the property. LPAs were granted access to the home by the Applicant. The Applicant and Applicant's spouse are the only adults residing in the home. There are no minor children residing in the home.

Days and hours of operation will be Monday - Friday from 7:30 AM to 5:30 PM. Applicant and Spouse completed his Preventative Health and Safety Training on 11/08/2023 and copies of the certifications are on file. Applicant and Spouse have current CPR and First Aid certifications which expire on 11/06/2025. Applicant and Spouse completed the Mandated Reporter Training for Child Care Workers on 11/15/2023 and copies of the certifications are on file. Copies of current TB test, MMR, Tdap, and flu (opt out) vaccinations for the Applicant and Applicant’s Spouse are on file. Because the Applicant rents/leases the home, proof of landlord notification is required. LPAs observed the Property Owner/Landlord Notification form (LIC 9151) that the Applicant confirms was provided to the property owner/landlord. Applicant obtained a signed Property Owner/Landlord Consent form (LIC 9149). Copies of both documents are on file. Applicant provided proof of control of property to the Department prior to today’s inspection and a copy of the lease agreement is on file. Applicant does not have liability insurance at this time and will issue Affidavit Regarding Liability Insurance for Family Child Care Home (LIC 282) to all enrolling families unless he obtains liability insurance in the future.

LPAs toured the indoor and outdoor areas of the home with the Applicant during today's inspection. There are no stairs, fireplace units, or wall heater units inside the home. Off limit areas inside the home: Kitchen, Bathroom (with the washer/dryer in it) and the Bedroom located off the living room. There are no off limit areas outside the home.

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Jessica Bongardt
LICENSING EVALUATOR SIGNATURE:	DATE: 12/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2023

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 CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: FERKEL, BRANDON	FACILITY NUMBER: 434416567
	VISIT DATE: 12/15/2023

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The home is clean, orderly, (including heating and ventilation) for safety & comfort. Applicant has a valid phone in the home (#408-598-7032). There are sufficient toys, supplies, and equipment for the day care children both indoors/outdoors. LPAs observed a fully charged fire extinguisher (2A10BC), working combo smoke & carbon monoxide detectors, and fenced patio. LPAs observed a community swimming pool in the middle of the complex that is adequately fenced with a self-latching gate. Applicant states that the swimming pool is only accessible to residents via key card. Applicant states that the day care children will not use the swimming pool. Applicant states that he does not have any pets or weapons/ammunition in the home.

Cleaning Products, toxic agents, medications, and sharp objects were inaccessible to children. Applicant states that there are no poisons in the home. LPAs reminded Applicant that smoking, baby walkers, and similar items are not allowed in Family Child Care Homes. Applicant states that he will not administer any medication to the children at this time. Applicant states that a child will be isolated in the living room if necessary due to illness or communicable disease. Applicant has a First Aid kit with a touchless thermometer in the home.

Forms of discipline to be used by Applicant: Redirection, talking to the children, positive discipline. Applicant understands that children's personal rights should not be violated, including no corporal punishment. Supervision of children, capacity options, transportation of children, requirements for reporting suspected child abuse, unusual incidents/injuries, heat related illnesses, and requirements for assistant/substitute were also discussed. LPAs informed the Applicant that fire/disaster drills must be practiced at least once every 6 months and documented.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. 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) or (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.

Brandon Ferkel, Applicant, was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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.

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Jessica Bongardt
LICENSING EVALUATOR SIGNATURE:	DATE: 12/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2023

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 CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: FERKEL, BRANDON	FACILITY NUMBER: 434416567
	VISIT DATE: 12/15/2023

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LPAs reviewed with Brandon Ferkel, Applicant, 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. Prelicensing Entrance Checklist – Family Child Care Homes (LIC 9280) was provided to the Applicant.

LPAs discussed the safe sleep regulations with Brandon Ferkel, Applicant, and discussed the Child Care Licensing Safe Sleep webpage at: https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep, as an additional resource. LPAs also informed applicant 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.

On this date, 12/05/2023, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

Applicant was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

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

Exit interview conducted and report was reviewed with the Applicant, Brandon Ferkel, and advised Applicant that a small Family Child Care Home license will be approved upon manager's final review/approval.

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Jessica Bongardt
LICENSING EVALUATOR SIGNATURE:	DATE: 12/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2023

LIC809 (FAS) - (06/04)

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