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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434417309
Report Date: 11/16/2022
Date Signed: 11/16/2022 04:17:16 PM

Document Has Been Signed on 11/16/2022 04:17 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:RAMIREZ CHAVEZ, MIRIAMFACILITY NUMBER:
434417309
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: DATE:
11/16/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Miriam Chavez Ramirez TIME COMPLETED:
12:40 PM
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Licensing Program Analyst (LPA ) Anna Morales conducted an scheduled PRE LICENSING visit and was greeted by Applicant Miriam Chavez Ramirez. Applicant has relocated to this address from Sunnyvale, Ca. Days and hours of operation will be Monday to Friday 8:00am to 5:00PM. The Applicant informed LPA that she and her husband are the only only adults residing at this location.
The Applicant completed the Preventative Health Practices course on Health and Safety Practices-Lead and Nutrition in April 16,2022, Mandated Reporter Training (AB1207) on May 16, 2021 and Pediatric First Aid/CPR.on 3/27/2021. Proof of completion for these certifications are on file. The Applicant's copies of immunization records are also on file. The Applicant states that she does have liability insurance. Applicant will not be transporting children, but understands that children cannot be left in parked vehicles unattended at any time.

The facility is a single story home. LPA observed the main area of the home to be used for the day care will be in the living room(#1), bedroom #1 and in bedroom #2. Applicant has a designated area in the home where a child(ren) can be isolated if exhibiting signs of illness. LPA observed barricades in front of the fire place in the main living room(off limits) and the other living room(#1). In living room (#1), there is a barricade in front of a wall heater. In Bedroom Number One, there is a barricade in front of the the wall heater. LPA observed the home is clean and orderly. Off limit areas inside the home: another bedroom number two, bedroom number three, second living room, laundry room, kitchen, garage, the left and right side of the house. Children have access to living room( #1) the backyard/ porch and the bathroom between living room #1 and Bedroom #1. LPA observed a enclosed patio with age appropriate toys. There are mats underneath the climbing structure.
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Anna Morales
LICENSING EVALUATOR SIGNATURE: DATE: 11/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/16/2022
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: RAMIREZ CHAVEZ, MIRIAM
FACILITY NUMBER: 434417309
VISIT DATE: 11/16/2022
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Applicant stated that the parents will drop off/pick up their children from the backyard. (Parents will enter/exit through the gate of the right side of the house). LPA observed the home has working smoke/carbon monoxide detectors and two charged fire extinguishers.

The Applicant states that she does not smoke and understands that smoking is prohibited during day care hours. The Applicant states that she does not have any baby walkers/inclined sleepers in the home and understands that baby walkers/inclined sleepers are not allowed in the day care.

LPA observed the kitchen which is not accessible to the children. There are no sharp utensils, lighter/matches or open bottles of alcohol accessible to children. The Applicant understands that any food/drink which is brought by parent(s) must be properly labeled with the child(ren) name and properly stored or refrigerated.

LPA observed the living room, play room with appropriate table/ chairs, appropriate age activities, and storage area for children's personal belongings. Applicant will be using portable heaters when applicable and will place them in a location where the children will not have access to them.

All of the detergents or cleaning compounds, sharps, medicines or other items which could pose a danger if readily available to children were stored where they are inaccessible, out of reach of children. No bodies of water observed. The Applicant states that there are no firearms in the home. The Applicant has a first aid kit in the home, which also has a thermometer and sufficient emergency supplies.



Forms of discipline used by Applicant: redirecting and talking. The Applicant understands that children's personal rights should not be violated, including no corporal punishment. Supervision of children, transportation of children, requirements for reporting suspected child abuse, unusual incidents/injuries, lead poisoning prevention, and requirements for assistant/substitute were also discussed with the Applicant during today's visit.
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Anna Morales
LICENSING EVALUATOR SIGNATURE:

DATE: 11/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/16/2022
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: RAMIREZ CHAVEZ, MIRIAM
FACILITY NUMBER: 434417309
VISIT DATE: 11/16/2022
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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.

Incidental Medical Services (IMS) policy was discussed with the Applicant today and stated that she will not take care of children if they are sick. and does not plan on administering medication to the day care children at this time. 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: http://www.ada.gov/childqanda.htm.

LPA discussed the requirements of AB 633 with the Applicant. The Applicant understands the AB 633 fact sheet/copy of Acknowledgement of Receipt of Licensing Reports (LIC 9224). LPA discussed "zero tolerance" related regulations with the Applicant and advised the Applicant of the assessment of an immediate $500 per day civil penalty for any violation of a "zero tolerance" related regulation. An ongoing civil penalty of $100 per day continues until the violation(s) is corrected. LPA reminded the Applicant of the applicable civil penalties for those adults who have not received fingerprint clearances, are not associated to the license, and who come in contact with or provide care and supervision to the children.

Licensure for Small Family Day Care pending on final review.
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Anna Morales
LICENSING EVALUATOR SIGNATURE:

DATE: 11/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/16/2022
LIC809 (FAS) - (06/04)
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