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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434417074
Report Date: 04/08/2024
Date Signed: 04/08/2024 02:10:57 PM

Document Has Been Signed on 04/08/2024 02:10 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:HERNANDEZ, MARIADELFACILITY NUMBER:
434417074
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 4DATE:
04/08/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:50 AM
MET WITH:Mariadel Hernandez TIME VISIT/
INSPECTION COMPLETED:
12:45 PM
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On 4/8/24 Licensing Program Analyst (LPA) Sheena Chin conducted an unannounced case management – licensee initiated for capacity increase. LPA met with the licensee, Mariadel Hernandez and explained the purpose of the inspection. Present were the licensee, her daughter (helper), and 4 children in care. The licensee submitted the application form (LIC 279) to apply for change of capacity on 1/24/24. The licensee’s small child care family home license was issued on 3/13/23. The fire clearance was granted on 3/28/24. Operating hours for the facility were from 7am to 5pm, Monday through Friday.

LPA observed that required postings were posted. LPA, along with the licensee toured the inside and outside of the home. LPA observed that 4 more bed mates were purchased and advised the licensee to carefully arrange the mates so that the walkways are not blocked. The licensee stated that she planned to purchase 3 more cribs and might use one of the bedrooms for infants napping area. The licensee stated that she would notify the licensing department when that happens.

The fire clearance was granted on 3/28/24 for large family child care home license and stated that areas not approved for daycare use: bedrooms, kitchen, hallway bathroom, garage, outside shed, and side yard. Additional area not approved also indicated on additional pages with hash-marks. LPA observed that there was not hash-marks on the hallway bathroom on additional pages. LPA reached out to the Fire Marshall, who stated “the hallway bathroom IS approved for daycare use.”

No deficiencies were cited. LPAs advised the licensee, Mariadel Hernandez that a license for capacity increase will be approved upon management review and approval.



Exit interview conducted and report was reviewed with Mariadel Hernandez. A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Sheena Chin
LICENSING EVALUATOR SIGNATURE: DATE: 04/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/08/2024
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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