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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434417309
Report Date: 06/14/2023
Date Signed: 06/14/2023 03:57:28 PM

Document Has Been Signed on 06/14/2023 03:57 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: 7DATE:
06/14/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
12:50 PM
MET WITH:Miriam Ramirez ChavezTIME COMPLETED:
01:35 PM
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Licensing Program Analyst (LPA) Anna Morales conducted a Case Management/ Increase of Capacity Inspection. The purpose of today’s visit is to ensure the facility is in compliance with Title 22 California Code of Regulations. LPA met with Licensee Miriam Chavez Ramirez and one staff. LPA toured the Facility both inside and outside during todays inspection. LPA observed the required posted materials, including the Facility License, Emergency Disaster Plan (LIC 610), Earthquake Preparedness Checklist (LIC 9148), Parents' Rights Poster (PUB 393) and Personal Rights (LIC 613A). Facility's operating days and hours are Monday to Friday 8:30AM to 5:00 PM.

Present today were seven children ( two infants, four preschool aged children and one elementary aged child).

The playground is surrounded by appropriate fencing. Shade is provided by the mature trees and patio cover. LPA did not observe any bodies of water at the site. No transportation is provided

The facility has requested increase of capacity to provide care and supervision for up to 14 children. Fire clearance was granted on June 6, 2023. LPA observed fully charged fire extinguisher and working smoke/carbon monoxide detectors.

No deficiencies cited, exit interview conducted and the report was reviewed with Miriam Ramirez Chavez. Application will be approved pending management approval.

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





SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Anna Morales
LICENSING EVALUATOR SIGNATURE: DATE: 06/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/14/2023
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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