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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434409404
Report Date: 11/10/2021
Date Signed: 11/10/2021 11:40:55 AM

Document Has Been Signed on 11/10/2021 11:40 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:TRAN, CHRISTINAFACILITY NUMBER:
434409404
ADMINISTRATOR:TRAN, CHRISTINAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 942-6636
CITY:MILPITASSTATE: CAZIP CODE:
95035
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 13DATE:
11/10/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:26 AM
MET WITH:Christina TranTIME COMPLETED:
11:30 AM
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On Wednesday, November 10, 2021 at 9:26 am, Licensing Program Analyst (LPA) Manel Estoesta conducted an unannounced Required One (1) Year visit. LPA met with Licensee Christina Tran and explained the purpose of the visit. Present on this visit were the Licensee's assistant, Licensee's daughter and thirteen preschool children (ages from 2-5), one of them is a Transitional Kindergarten qualified. Facility operates from Monday to Friday from 8am - 6pm.

LPA toured the home to conduct a Health and Safety Inspection with the Licensee. The home was clean and orderly, with heating and ventilation for the safety and comfort of children in care. LPA did not observe flies, other insects, and rodents during the inspection. The observed toys for children, play equipment and materials were safe and age appropriate. Bathroom was observed to be sanitary. Licensee stated that there were no weapons such as firearms stored on the premises. Only the Family Room with an attached bathroom is used for Day Care Children. All other areas inside the home are Off Limit. The backyard is fenced and half of the backyard is used for outdoor activity. The right side area of the backyard when facing the house is off limit and has a fence with a locked gate to prevent children from accessing. In this Off Limit , gated area is where Licensee had relocated her pond and an operating 2 tiers water fountain. Outdoor play equipment was observed to be in good condition.

A fully charged Fire extinguisher last serviced on December 2020 was observed. Carbon monoxide and smoke detectors were tested and proved to be functioning. Log shows that Disaster Drill was last conducted on October 2021. The home has received a 2019 Fire Department Permit and the will contact the Fire Marshall for an update on an inspection. The Licensee stated that she does not transport children at this time but Licensee understands that children cannot be left alone, unattended in parked vehicles at any time.

Licensee owns the house and licensee currently have the liability insurance.
SEE 809 C...
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Manel Estoesta
LICENSING EVALUATOR SIGNATURE: DATE: 11/10/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/10/2021
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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: TRAN, CHRISTINA
FACILITY NUMBER: 434409404
VISIT DATE: 11/10/2021
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CONTINUATION....

Facility's roster of children who are provided care was reviewed and a copy was obtained. Children’s files were reviewed, which included records of receipt for Parents' Rights Notice, Identification and Emergency Information, Consent for Emergency Medical Treatment form, and Immunization.
Licensee's file were reviewed, which included records of Criminal Record and Child Abuse Index Clearance, TB clearance, and required Training. Licensee's Pediatric First Aid and CPR certification expires on October 2022. Licensee stated that they have Immunization against Measles and Pertussis. LPA reminded Licensee that only the Influenza vaccination can be declined with a written declination.
Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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
Licensee was reminded that all adults 18 and over living or working in the home, 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.

LPA discussed the safe sleep regulations with licensee [or facility representative] and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee [facility representative] 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.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to [email protected]. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

No regulatory violation observed on this visit.

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

Exit interview conducted and report was reviewed with the licensee, Christina Tran..

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Manel Estoesta
LICENSING EVALUATOR SIGNATURE:

DATE: 11/10/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/10/2021
LIC809 (FAS) - (06/04)
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