434417362-10-12-2023-07-CC-AMOS-CVMUA7-20230913152414

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434417362
Report Date: 09/13/2023
Date Signed: 10/12/2023 12:16:03 PM

Document Has Been Signed on 10/12/2023 12:16 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:	VALDEZ, VANESSA G.		FACILITY NUMBER:	434417362
ADMINISTRATOR:	VALDEZ, VANESSA G.		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(408) 963-8169
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95118
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 0	DATE:	09/13/2023
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Vanessa G. Valdez		TIME COMPLETED:	11:30 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	Licensing Program Analyst (LPA) Anna Morales conducted a scheduled Pre-Licensing Visit and was greeted by Vanessa G. Valdez. Applicant submitted an Application for a Large Family Day Care. Hours of operation will be 7:30-5:30pm, ages 18 months -5 years of age. Fire clearance was approved on 8/22/23.Applicant has completed Pediatric first aid/CPR (expires on 11/16/2023), Preventative Health and Safety Training( completed 7/17/2023) and Mandated Reporter Training (expires on 1/30/2025). Applicant has immunization against pertussis, measles and influenza on file. LPA observed toys for the children. There were no baby walkers observed during today's inspection. Applicant understands that baby walkers and smoking is not permitted in the home. There a fully charged fire extinguisher and working carbon monoxide/smoke detectors. LPA discussed with Applicant that fire extinguisher need to be serviced every year or obtain a new fire extinguisher. Applicant rents the home and the Owner/Landlord Notification form (LIC 9151) is on file and also obtained Owner/Landlord consent (LIC9149) for day care. Applicant does not have liability insurance at this time, and will issue affidavit regarding liability insurance for FCCH. Applicant stated that she and both of her parents are the only Adults residing at this location. LPA provided the LIC 311D, Forms/Records To Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted. 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. 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.

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Anna Morales
LICENSING EVALUATOR SIGNATURE:	DATE: 09/13/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2023

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

FACILITY NAME: VALDEZ, VANESSA G.	FACILITY NUMBER: 434417362
	VISIT DATE: 09/13/2023

NARRATIVE

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LPA discussed the safe sleep regulations with Applicant. 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-andresources/safe-sleep as an additional resource. LPA also informed licensee [or 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.

Incidental Medical Services (IMS) policy was discussed. Applicant stated that she is not certain if she will provide IMS services at this time. 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/.

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

Prior to approval to Licensure, Applicant Vanessa Valdez needs to:
1. Secure the swimming pool with a fence that has a gate that shall swing away from the pool, self-close and have a self-latching device located no more than six inches from the top of the gate
2. The Patio/Deck which is being used as part of the fence surrounding the center of the pool will be reviewed by Management
3. Secure the Bigger Red slide in the backyard and place resilient material underneath this play structure to absorb the falls.
4. Fix the tripping hazard that is two inches high located in the exit area of the playground.

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Anna Morales
LICENSING EVALUATOR SIGNATURE:	DATE: 09/13/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2023

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

FACILITY NAME: VALDEZ, VANESSA G.	FACILITY NUMBER: 434417362
	VISIT DATE: 09/13/2023

NARRATIVE

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LPA observed toured the inside and outside of the Family Day Care. The house is a two story house and the entire upstairs is off limits to the children. There is a barricade that is front of the stairs. Children will have access to the day care room(back living room),bathroom, and fenced backyard. There is a covered fire place inside the day care room. Off limits on the first floor is, the kitchen, garage, patio/deck and the front living room.
LPA's Anna Morales and Mel Matos observed the swimming pool (max. depth: 6 ft) in the backyard. On one side of the fence that is surrounding the swimming pool is a vinyl(black mesh)pool fence which on one side is connected to the wood patio/deck and the other to the end of the fence. Measurements of the fence and the patio were measured. The vinyl fence has four and half sections connected to each other by silver hooks. Four sections measure 10 feet and the half measured five feet. The fence does not have a self-latching gate that is self closing. To enter the swimming pool, Applicant had stated that she unhooks the section that is hooked into the patio/deck. The vinyl fence measured five feet in height. Gaps were observed between each of these sections, measured approximately 3 inches. The patio/deck serves as part of the fence surrounding one section(middle) of the swimming pool. The patio/deck measured 5 ft 4 inches in height. There are gaps between the patio measuring approximately 5 inches near the patio steps and at the end of the patio, the gap measured six inches. One can enter/exit from the patio from the kitchen. The patio has three steps and there is child gate, however, the gate can't be secured. Applicant stated that the children will not have access to the swimming pool and the patio is off limits.
LPA's observed that there was no resilient material to absorb the fall on one of the climbing structures with the tall red slide and The Red slide is lose. There is a tripping hazard that is two inches high when the child exits the playground.

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. LPA informed Applicant that fire/disaster drills must be practiced at least once every 6 months and documented.

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Anna Morales
LICENSING EVALUATOR SIGNATURE:	DATE: 09/13/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2023

LIC809 (FAS) - (06/04)

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