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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434409404
Report Date: 10/24/2023
Date Signed: 10/24/2023 02:59:51 PM

Document Has Been Signed on 10/24/2023 02:59 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
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:
10/24/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Licensee Christina TranTIME COMPLETED:
03:15 PM
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On Tuesday, October 24, 2023 at 1:45 pm, Licensing Program Analyst (LPA) Manel Estoesta conducted a Required 1 Year Visit. LPA met with the Licensee Christina Tran and explained the purpose of the visit. Present on this visit were the Licensee's assistant, Licensee's 15 year old son, 13 preschool children. Facility operates from Monday to Friday from 8am - 6pm.

LPA conducted a Health and Safety Inspection with the Licensee. The home is a one-story home. The home is neat and clean with heating and ventilation for safety and comfort.

The On-Limit Area (accessible to children in care) Family Room with an attached bathroom and half of the backyard is used for outdoor activity. The backyard play area is completely fenced.
The Off-Limit areas are all bedrooms, living room, dining room, kitchen, garage and the other half gated backyard which will be inaccessible to children in care by closed and or locked doors and or a fence with visual supervision. There is a pond and an operating 2 tiers water fountain located in the Off-Limit other half gated backyard.

The designated isolation area for a child who becomes ill while in care is the living room. There are ample age-appropriate toys that appear to be safe and in good condition. All hazardous materials and toxins are kept out of the reach of children and it was observed that there are no toxins or hazardous items accessible today.

The home has a fully charged 3A40BC fire extinguisher, working smoke detector, working carbon monoxide detector and working telephone. The fireplace is screened to prevent access by children. Per licensee, there are no firearms in the home. The licensee conducts and documents fire and disaster monthly, with the last one conducted on 10/2/2023. Licensee owns the house and has childcare liability insurance with DCI.
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Manel Estoesta
LICENSING EVALUATOR SIGNATURE: DATE: 10/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/24/2023
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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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: 10/24/2023
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The licensee's CPR and First Aid certificate expires on 10/28/2024. Licensee and Licensee's assistant completed the Child Care Providers training online at https://mandatedreporterca.com/. Licensee and Licensee's assistant have records of Measles and Pertussis immunization, Influenza vaccination and TB clearance. LPA reminded the Licensee that only the Influenza vaccination can be decline with a written declination.

Facility roster of children was reviewed. Children’s files were reviewed, which included records of receipt for Parents' Rights Notice, Identification and Emergency Information, Consent for Emergency Medical Treatment form, Immunization and LIC 9150. Licensee stated that she does not transport children at this time.

LPA Estoesta discussed and provided copies of the following.
1.Childcare Expansion Grant Program, the Santa Clara County Childcare Resource and Referral (R&R) Program 2023-2024 HEALTH AND SAFETY TRAINING REIMBURSEMENT and FREE training is available to Santa Clara County Mandated Reporters working at daycare/childcare facilities
2. 102416.5 Staffing Ratio and Capacity A large family day care home may provide care for more than 12 children and up to and including 14 children, at least one child is enrolled in and attending kindergarten or elementary school and a second child is at least six years of age.

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\

LPA discussed the safe sleep regulations with licensee 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 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.
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Manel Estoesta
LICENSING EVALUATOR SIGNATURE:

DATE: 10/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/24/2023
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: 10/24/2023
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Directors were reminded that all adults 18 and over, 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 Child Care Center. 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.

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/inspection-process.

In the areas that were evaluated, no deficiencies were observed at the time of the visit.

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

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

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: 10/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/24/2023
LIC809 (FAS) - (06/04)
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