434417415-4-19-2024-07-CC-SCHN-D4GSDJ-20240419134715

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434417415
Report Date: 04/19/2024
Date Signed: 04/19/2024 01:47:24 PM

Document Has Been Signed on 04/19/2024 01:47 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:	THOI, LINH		FACILITY NUMBER:	434417415
ADMINISTRATOR/ DIRECTOR:	LINH THOI		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(408) 661-7053
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95116
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 0	DATE:	04/19/2024
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:00 AM
MET WITH:	Linh Thoi		TIME VISIT/ INSPECTION COMPLETED:	11:15 AM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Page 1. On 4/19/24 Licensing Program Analyst (LPA) Sheena Chin conducted a scheduled Pre-Licensing visit. LPAs met with the applicant Linh Thoi. The applicant submitted an application for change of location of a large Family Child Care Home on 3/20/24. The licensee stated that the previous location has been closed in March. The licensee surrendered the license for the previous facility to LPA. The new facility will operate from 8am to 6pm, Monday through Friday, and serve children from 3 months to 6 years of age. The applicant stated that she owned this new property. Observations The applicant and LPA toured inside and outside of the facility. The facility is a one-story house. Off limits are all the bedrooms, kitchen and garage. Fully charged fire extinguisher, 2A10BC, was placed in the kitchen. LPA discussed with the applicant that the fire extinguisher needs to be fully charged or replaced with a new one. The fireplace was blocked by bookshelves. A wall unit for heating and air conditioning was observed in the child care area. The licensee stated that there’s no heating in the house except the master bedroom. Cleaning supplies were stored in locked cabinets, inaccessible to children. Toys were observed inside and outside of the house. The licensee stated that she brought all the toys from the previous location. LPA advised the licensee to use the website of the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ for recalls for their purchases. There were no baby walkers observed during today's inspection. Applicant understands that baby walkers and smoking are prohibited in the facility. continue to page 2.

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Sheena Chin
LICENSING EVALUATOR SIGNATURE:	DATE: 04/19/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/19/2024

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 CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: THOI, LINH	FACILITY NUMBER: 434417415
	VISIT DATE: 04/19/2024

NARRATIVE

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Page 2.

Required Documents
The applicant has completed Pediatric First Aid/CPR (expires on 9/20/23), Preventative Health and Safety Training( completed 7/10/22). The applicant has proofs of immunizations against pertussis, measles. The applicant stated that she’s willing to have the flu shot. The applicant surrendered the licensee for the previous location to LPA and completed a statement for that.

The applicant stated that adults residing at this facility include the licensee and her husband. A review of staff records indicate that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. The 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, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

The applicant has a certificate of mandated reporter training, expired on 6/17/22.
The applicant provided a copy of buyer’s statement from a title company as proof of control of the property.

The applicant stated that she will purchase liability insurance, and understood that if she does not provide it, she needs to have each parent sign LIC282, affidavit regarding liability insurance for family child care home.

LPA reviewed with applicant the LIC126, 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.

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SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Sheena Chin
LICENSING EVALUATOR SIGNATURE:	DATE: 04/19/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/19/2024

LIC809 (FAS) - (06/04)

Page: 2 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

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: THOI, LINH	FACILITY NUMBER: 434417415
	VISIT DATE: 04/19/2024

NARRATIVE

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Discussions
The applicant understood that children's personal rights should not be violated, including no corporal punishment. LPA discussed with the applicant about isolation of sick children, supervision of children, capacity options, transportation of children, requirements for reporting suspected child abuse, unusual incidents/injuries.
LPA informed the applicant that fire/disaster drills must be practiced at least once every 6 months and documented.

LPA discussed the safe sleep regulations with the 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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. 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) 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.

Information
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.

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SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Sheena Chin
LICENSING EVALUATOR SIGNATURE:	DATE: 04/19/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/19/2024

LIC809 (FAS) - (06/04)

Page: 3 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

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: THOI, LINH	FACILITY NUMBER: 434417415
	VISIT DATE: 04/19/2024

NARRATIVE

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Information
The applicant was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

On this date, 3/20/24, 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 addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have 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.

A fire clearance granted from the San Jose Fire Department was received on 4/12/24: Areas not approved for day care use: all bedrooms, garage, water-heater area (space between living room and hallway bathroom and backyard shown in diagram), sides of the house and kitchen. Areas approved: living room, hallway bathroom and backyard.

Exit interview was conducted and the report was discussed with applicant, Linh Thoi. LPAs advised the applicant that her large family child care home license is pending upon management review and approval.

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Sheena Chin
LICENSING EVALUATOR SIGNATURE:	DATE: 04/19/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/19/2024

LIC809 (FAS) - (06/04)

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