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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434417081
Report Date: 02/24/2023
Date Signed: 02/24/2023 03:00:58 PM

Document Has Been Signed on 02/24/2023 03:00 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:CHEN, YINGFACILITY NUMBER:
434417081
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
02/24/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Ying ChenTIME COMPLETED:
03:20 PM
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Licensing Program Analyst (LPA) Oscar Huang conducted an announced, scheduled Pre-Licensing inspection at 1850 Charmeran Ave., San Jose 95124. LPA met with Applicant, Ying Chen. Applicant is applying for a license to operate a Small Family Child Care Home with a maximum capacity of eight at the address listed above. LPA noted that applicant was licensed at 6387 Rainbow Drive, San Jose, License # 434415347 started on 11/09/2017, and closed on 09/30/2019. LPA observed licensee's husband and her teenage son, but no children in care the home during the inspection. The applicant owns the house. The Santa Clara County property Tax statement with licensee's name is on file. The adults live in the home are licensee and her husband.

Smoke and carbon monoxide detectors were tested and proved to be functioning. The home’s disaster plan of action was discussed along with the requirement for the home to conduct and document fire and disaster drills at least once every six months. LPA reminded Applicant that smoking is not allowed in family childcare homes and baby walkers shall not be allowed on the premises of the family childcare home in accordance with Health and Safety Code Section 1596.846(b) and (c).

Days and hours of operation will be Monday through Monday 7:00AM to 7:00PM. Applicant has documented proof of immunity against Measles, Pertussis and a statement for not taking Influenza this year, as well as proof of cleared Tuberculosis within 12 months. The applicant's certification of completion of the AB1207 Mandated Reporter Training exp 12/27/2022. Her Pediatric CPR & First Aid certification are also current exp 11/2024, & completed the 8 hours Preventive Health & Safety Training on 12/17/22. The applicant and her tenant have Clearances for Criminal Record and Child Abuse Index Background Check.
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Yangcheng Huang
LICENSING EVALUATOR SIGNATURE: DATE: 02/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/24/2023
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-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: CHEN, YING
FACILITY NUMBER: 434417081
VISIT DATE: 02/24/2023
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LPA reminded Applicant about the applicable civil penalties for those adults who have not received fingerprint clearances, who are not associated to the license, and who come in contact with or provide care and supervision to the children. For an initial violation, civil penalty amounts to $100.00 per person per day up to $500.00 per person. For a subsequent violation within a 12-month period, civil penalty amounts to $100.00 per person per day up to $3000.00 per person.

LPA inspected the indoor and outdoor areas of the home. Off limits areas in the home are all three bedrooms, master bathroom, dinning room, kitchen, and garage. The home is with a fully fence in backyard and will be use for outdoor activity. Off limits area in the back yard is two sides beyond gated fence to ensure inaccessible to children. LPA observed appropriate children’s play structure and toys. Applicant states she will be supervising the children while they participate in all outdoor activities. No Bodies of water observed.

The home is clean and orderly, with heating and ventilation for safety and comfort of children in care. Applicant stated that there are no weapons such as firearm stored on the premises. Detergents, cleaning compounds, sharps, medicines, and other items which could pose a danger if readily available to children were stored where they are inaccessible, out of reach of children. The home has no fireplace. LPA reminded Applicant that poisons need to be locked.

Applicant stated that the form of discipline to be used are talking and redirecting the children. Applicant understands that children's personal rights should not be violated; including no corporal punishment. Applicants stated that she understands that the children have personal rights that cannot be waived or abridged regardless of consent or authorization from the child’s authorized representative.

LPA went over the records that need to be maintained at the home with Applicant.
Applicant is encouraged to visit the Department’s website at www.cdss.ca.gov [Shortcut: www.ccld.ca.gov] to access resources for Providers, Regulations, Online option to pay Annual License fee, Adoption of Laws, etc.
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Yangcheng Huang
LICENSING EVALUATOR SIGNATURE:

DATE: 02/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2023
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-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: CHEN, YING
FACILITY NUMBER: 434417081
VISIT DATE: 02/24/2023
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LPA informed Applicant that if she decides to not carry liability insurance for the Family Day Care, she will have to maintain in children’s file an affidavit regarding liability insurance signed by each parent of the children that will be enrolled. LPA reviewed with Applicant the violations that would result in an immediate assessment of civil penalty in the amount of $500.

LPA also discussed with Applicant about the continuing requirements, which include but are not limited to the following topics: (1) Separating sick children when they show signs of illness; (2) Supervision of Children; (3) Capacity Options; (4) transportation of children; (5) Procedures for Reporting Suspected Child Abuse and Unusual Incidents/Injuries;
LPA reviewed with 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.
LPA discussed the safe sleep regulations with applicant 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 the 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. 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.

The report was discussed and verbally translated into Chinese during the exit interview with Applicant Ying Chen.

Based on today's inspection, LPA advised applicant that a small Family Child Care Home license will be approved pending on Licensing Management for final review and approval.
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Yangcheng Huang
LICENSING EVALUATOR SIGNATURE:

DATE: 02/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2023
LIC809 (FAS) - (06/04)
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