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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434413894
Report Date: 04/16/2024
Date Signed: 04/17/2024 09:06:37 AM

Document Has Been Signed on 04/17/2024 09:06 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
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:NGUYEN,NGHIA HIEUFACILITY NUMBER:
434413894
ADMINISTRATOR/
DIRECTOR:
NGUYEN,NGHIA HIEUFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 401-9729
CITY:SAN JOSESTATE: CAZIP CODE:
95135
CAPACITY: 14TOTAL ENROLLED CHILDREN: 10CENSUS: 8DATE:
04/16/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:50 AM
MET WITH:Nghia Hieu NguyenTIME VISIT/
INSPECTION COMPLETED:
12:15 PM
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On 04/16/2024 at 8:50am, Licensing Program Analyst (LPA), Farida Raja, conducted an unannounced annual inspection. LPA was granted access to the home by Licensee, Nghia Nguyen and explained the nature of today’s inspection. Present in the home were licensee, two assistant's (Licensee's spouse and mother) and eight children including four infants and four preschool age. Licensee was operating within the ratio and capacity requirements of the license. Days and hours of operation are Monday to Friday, 8:00 am to 5:30 pm. LPA observed all required posted materials near the front entrance to the home. The adults that reside in the home are Licensee, spouse, licensee's mother, licensee's father and cousin (Hoai Nguyen). Licensee has two minor children residing in the home. Licensee submitted an updated Application for Family Child Care Home (LIC 279) to LPA. During today's inspection Licensee informed LPA that they plan to move to Riverside County and start a Family Childcare Home at that location. Licensee stated that they have been in communication with the Riverside Regional Office regarding submission of a new application. Licensee stated that they plan to close this location on June 29, 2024 and will contact the San Jose Regional Office to inform them of the exact date of closure.

LPA toured the indoor and outdoor areas of the home during today's inspection. Licensee has a working telephone in the home (408-401-9729). LPA observed sufficient materials, toys, and play equipment for the day care children. The home has central heating/cooling and ventilation for comfort of children. The home is two story and LPA observed barricaded stairs during today's inspection. Off limit areas inside the home: entire upper level, kitchen and attached garage. LPA observed a fireplace with a glass cover in the family room of the home. Off limit areas outside the home: fenced area at the back of the home. Backyard is fenced and both sides of the home are gated. Licensee stated that they have not been taking children out due to the rain and cold weather. There are no bodies of water observed. LPA observed that the bathroom used by children was in operating condition. Toilets and faucet are clean and operable. The shower area is free of any hazards.

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SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Farida Raja
LICENSING EVALUATOR SIGNATURE: DATE: 04/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/16/2024
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: NGUYEN,NGHIA HIEU
FACILITY NUMBER: 434413894
VISIT DATE: 04/16/2024
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LPA observed a fully charged 3A40BC fire extinguisher and working smoke/carbon monoxide detectors. Licensee states that she does not have any weapons or pets in the home. All detergents, cleaning compounds, poisons, medications, sharp objects and other similar items were observed to be stored inaccessible to children. Licensee understands that smoking is prohibited in the home.

Drinking water is readily available for children in the home via individual water bottles. Licensee states that she provides meals and snacks to the children in care. Parents provides meals and snacks for children with food preferences or dietary restrictions. Licensee understands that any food brought from home shall be labeled with each child's name and properly stored or refrigerated. Licensee states that a child will be isolated in the family room if necessary due to illness or communicable disease.

LPA reviewed a current Child Care Facility Roster and Fire/Disaster drill log during today's inspection. Fire/disaster drill was last conducted on 4/10/2024. LPA obtained copy of children's roster.

Seven (7) children’s files were reviewed during today's inspection. Licensee does not have liability insurance for the day care and issues the Affidavit Regarding Liability Insurance for Family Child Care Home (LIC 282). LPA reviewed four infant's files and the files were complete with the required forms including 15-minute nap checks.

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. During today's inspection LPA observed an infant using a pacifier with a clip holder that was attached to it. LPA did not observed infant sleeping with the pacifier. LPA advised licensee that as per Safe Sleep regulations there shall not be anything attached to the pacifier like clip holders or toys. LPA also observed 2 play yards that have tears on their meshed sides. LPA informed Licensee to replace all items used for children which are not in good repair so they are safe for children in care. LPA did not observe any children napping during today's inspection. 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.

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SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Farida Raja
LICENSING EVALUATOR SIGNATURE:

DATE: 04/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/16/2024
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: NGUYEN,NGHIA HIEU
FACILITY NUMBER: 434413894
VISIT DATE: 04/16/2024
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LPA reviewed three staff files (Licensee and two assistant's) for the required forms and found them to be current and up to date. A review of staff records indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.
Licensee has current Pediatric CPR/First Aid certification (expires 4/9/2025). Licensee and staff have the required immunization in file for measles, pertussis and influenza and are current with Mandated Reporter Training for Child Care Workers.

Licensee was reminded that all adults 18 and over living or working in the home, 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.

Supervision of children was discussed with Licensee, and she understands that she or a qualified adult must be present in the home during day care hours and ensure that the children are supervised at all times. The Licensee understands her capacity options and she understands that she cannot have more than 14 children in the home at any time and a qualified assistant must be present. Licensee understands in absence of a helper her license capacity is reduced to 8 and ratio (age of the children) must be observed.

LPA discussed "zero tolerance" related regulations which includes the assessment of an immediate $500 per day civil penalty for any violation of a "zero tolerance" related regulation. A $500 immediate civil penalty 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. An ongoing civil penalty of $100 per day continues until the violation(s) is corrected.

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)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/.

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SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Farida Raja
LICENSING EVALUATOR SIGNATURE:

DATE: 04/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/16/2024
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: NGUYEN,NGHIA HIEU
FACILITY NUMBER: 434413894
VISIT DATE: 04/16/2024
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Licensees stated that they transport children. LPA reminded Licensee that children cannot be left in parked vehicles unattended at any time, the motor vehicles used to transport children shall be maintained in safe operating conditions, and all vehicle occupants must be secured in an appropriate restraint system.
Licensee was informed of the MyChildCarePlan.org website; 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. Licensee was encouraged to frequently visit our website at www.ccld.ca.gov for licensing updates and regulations.

During the exit interview, Licensee confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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.

One technical advisory was cited as a result of today's inspection. Exit interview conducted and report was reviewed with the Licensee, Nghia Hieu Nguyen.

A NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 DAYS.
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Farida Raja
LICENSING EVALUATOR SIGNATURE:

DATE: 04/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/16/2024
LIC809 (FAS) - (06/04)
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