434417396-1-19-2024-07-CC-FRAA-CZN46V-20240119175009

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434417396
Report Date: 01/19/2024
Date Signed: 01/19/2024 05:50:21 PM

Document Has Been Signed on 01/19/2024 05:50 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:	YANG, YANG		FACILITY NUMBER:	434417396
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	01/19/2024
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Yang Yang		TIME COMPLETED:	03:35 PM

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On 01/19/2024 at 1:30pm, Licensing Program Analyst (LPA), Farida Raja met with Applicant, Yang Yang, to conduct an announced pre-licensing inspection. LPA was granted access to the home by the Applicant and explained the purpose of today's visit. Per applicant, the adults that reside in the home are applicant and spouse. Licensee has one minor child residing in the home. The home is two story with 6 bedrooms and 3 bathrooms.

Days and hours of operation will be Monday - Friday from 8:30 AM- 6:00 PM. Applicant completed her Preventative Health and Safety Child Care Training on 09/23/2023 and a copy of the certification is on file. Applicant's CPR and First Aid certifications are current and expire on 08/19/2025. Applicant has completed the Mandated Reporter Training for Child Care Workers on 08/28/2023. A copy of current TB test (applicant, and spouse), MMR, Tdap and influenza vaccinations for the applicant are on file.

Applicant owns the home and provided a grant deed as proof of control of property. Applicant does not have liability insurance at this time and stated that she plans to obtain daycare insurance once licensed.

LPA toured the indoor and outdoor areas of the home with the applicant during today's inspection. LPA observed barricaded stairs leading to the second level. Off limit areas inside the home: barricaded kitchen, two downstairs bedrooms, one downstairs bathroom, covered and gated shelf area, attached garage and entire second level. LPA inspected home for any health and safety hazards. Areas accessible to children were inspected to ensure that they are clean and orderly. There are sufficient toys, supplies, and equipment for the day care children. The floor is free of tripping hazards. LPA observed edges of sharp furniture to be child proofed. The home has central heating, cooling and ventilation for comfort of children. LPA observed the bathroom used by children was in operating condition. Toilets and faucet are clean and operable. Shower area is free of any hazards. Off limit areas outside the home: Fenced front yard.

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SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Farida Raja
LICENSING EVALUATOR SIGNATURE:	DATE: 01/19/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/19/2024

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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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: YANG, YANG	FACILITY NUMBER: 434417396
	VISIT DATE: 01/19/2024

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Backyard is fenced and both sides of the home are gated. Applicant understands that children must be supervised at all times while outdoors. LPA observed artificial grass to absorb falls. There are no bodies of water observed. LPA observed a play structure for preschool age children in the backyard that was placed against a fence. Applicant stated that she is not planning to use it at this time. LPA advised applicant that if play structure is used, she should follow manufacturer instructions on age requirement, place play structure away from the fence and provide resilient material under high climbing structures to absorb falls.

Licensee has a working telephone in the home (312-714-6038). LPA observed a fully charged fire extinguisher (3A40BC) in the kitchen area and a working smoke and carbon monoxide detector in the family room. LPA informed the applicant that fire/disaster drills must be practiced at least once every 6 months and documented. Applicant states that she does not have any weapons/ammunition or pets in the home. Applicant stated that cleaning products, laundry detergents and similar toxic agents are placed in the garage. Knives and sharp objects were stored on high counters and made inaccessible to children. Applicant has a first aid kit in the downstairs shelf area. LPA reminded applicant that smoking, baby walkers, bouncers, jumpers, and similar items are not allowed in Family Child Care Homes. Applicant currently has one (1) crib available for napping. Applicant stated that she will have parents provide sleeping bags and bedding for preschool age children. Applicant stated that infants will nap in the on limit bedroom and older children will sleep in the family room of the home.

Applicant states that she will provide meals and snacks for the day care children. LPA reminded the Applicant that any food/liquid products provided by parents will need to be labeled with each child's individual name(s). Drinking water will be provided to children via individual water bottles and refilled using filtered water.

LPA advised applicant to have postings near the entrance so it is visible to parents/authorized representatives. 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.

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SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Farida Raja
LICENSING EVALUATOR SIGNATURE:	DATE: 01/19/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/19/2024

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: YANG, YANG	FACILITY NUMBER: 434417396
	VISIT DATE: 01/19/2024

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Form of discipline will be to talk to child to help them understand and to calm them down. Applicant understands that children's personal rights should not be violated; including no corporal punishment. Isolation of sick children, 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. Applicant stated that in case of a communicable disease child will be isolated in the downstairs bedroom, away from the other children, until parent pick up.

LPA discussed the requirements of Assembly Bill(AB) 633 with the Applicant. Applicant understands the AB 633 fact sheet/copy of Acknowledgement of Receipt of Licensing Reports (LIC 9224). LPA discussed "zero tolerance" related regulations and advised that the assessment of an immediate $500 per day civil penalty for any violation of a "zero tolerance" related regulation. A $500 immediate civil penalty and $100 per day violation until corrected is assessed for serious violations such as absence of supervision, accessible bodies of water, accessible firearms, refused entry of licensing staff, presence of an excluded person, and violations that result in illness or injury.

LPA discussed the safe sleep regulations with 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. LPA 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.

LPA reviewed with applicant the Forms/Records to Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted. Entrance Checklist was provided to the applicant. Applicant states that she will not provide transportation and LPA reminded applicant that children cannot be left in parked vehicles unattended at any time.

Incidental Medical Services (IMS) policy was discussed. Applicant will wait until facility opens to determine IMS needs. For IMS information see PIN 22-02- CCP. When any IMS is provided, a plan for providing IMS must be submitted to the Department.

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SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Farida Raja
LICENSING EVALUATOR SIGNATURE:	DATE: 01/19/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/19/2024

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: YANG, YANG	FACILITY NUMBER: 434417396
	VISIT DATE: 01/19/2024

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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.

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 address. 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 child care 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, Yang Yang. LPA advised Applicant that a small Family Child Care Home License will be issued upon submitting floor plan/sketch (LIC 999) of the off limit second level and supervisor approval.

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Farida Raja
LICENSING EVALUATOR SIGNATURE:	DATE: 01/19/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/19/2024

LIC809 (FAS) - (06/04)

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