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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434417362
Report Date: 12/06/2023
Date Signed: 12/14/2023 10:34:58 AM

Document Has Been Signed on 12/14/2023 10:34 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 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 JOSESTATE: CAZIP CODE:
95118
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: DATE:
12/06/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Vanessa ValdezTIME COMPLETED:
11:55 AM
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Licensing Program Analysts Anna Morales and Mel Matos conducted a Scheduled Pre-Licensing inspection. LPA's met Vanessa's father Julio Valdez and Applicant Vanessa Valdez. The purpose for this inspection is to observe the backyard and the swimming pool.

LPA's observed a gate that swings away from the pool. There is a self-latching device located no more than six inches from the top of the gate. LPA's observed silver duct tape holding the mesh material in place. This gate is attached to the patio. Entrance/Exit to the patio is the kitchen. Applicant stated that both of these areas are off limits to the children. (There are three stairs that lead to the backyard from the patio, and Applicant stated that she will place a barrier so that they children don't have access).

LPA's measured the raised desk patio area adjacent to the kitchen area and it measured 22.5 inches off the ground. Measurements were taken from the bottom of the patio to where the railing, measuring at 3 ft 6 inches. The patio is accessible to the swimming pool and is easily climbable. There are openings on the patio fence and they measured five inches apart. The swimming pool view is obstructed from the kitchen area.

The last panel/fence surrounding the swimming pool has a no seam at the bottom and it loose on the top. Applicant will have to ensure that there is seam and that the fence is no longer loose. The fence is anchored on soft dirt and can be easily lift. The fence is also secured to the end of the fence with a latch. The plants/bush don't allow easy access to this part of gate surrounding the swimming pool.

(Continue on LIC809C)
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Anna Morales
LICENSING EVALUATOR SIGNATURE: DATE: 12/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/06/2023
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: 12/06/2023
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LPA's observed that the red slide in the back is secured and resilient material has been placed underneath the play structure to absorb the falls. LPA's observed the ramp/step and it is not secured.

Prior to approval to Licensure, Applicant Vanessa Valdez needs to:

1. Remove the silver duct tape holding the mesh material in place (where the lock is) will need to removed and will need to be secured

2. The last panel/fence surrounding the swimming pool has a no seam at the bottom and it loose on the top. Applicant will have to ensure that there is seam and that the fence is no longer loose. The fence is anchored on soft dirt and can be easily lifted. The fence is also secured to the end of the fence with a latch. The plants/bush don't allow easy access to this part of gate surrounding the swimming pool.

3. Entrance/Exit to the patio is the kitchen. LPA's measured the raised desk patio area adjacent to the kitchen area and it measured 22.5 inches off the ground. Measurements were taken from the bottom of the patio to the railing, measuring at 3 ft. 6 inches.
Patio/Deck which is being used as part of the fence surrounding the center of the pool will need to be at least five feet high.

4. The patio is accessible to the swimming pool and is easily climbable. There are openings on the patio fence and they measured five inches apart. The swimming pool view is obstructed from the kitchen area.
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Anna Morales
LICENSING EVALUATOR SIGNATURE:

DATE: 12/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/06/2023
LIC809 (FAS) - (06/04)
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