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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434417364
Report Date: 08/08/2023
Date Signed: 08/08/2023 10:38:03 AM

Document Has Been Signed on 08/08/2023 10:38 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:WOOD, HEATHERFACILITY NUMBER:
434417364
ADMINISTRATOR:WOOD, HEATHERFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 266-6497
CITY:SAN JOSESTATE: CAZIP CODE:
95118
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
08/08/2023
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Heather WoodTIME COMPLETED:
11:00 AM
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On 08/08/2023: Licensing Program Analyst (LPA) Pete Hernandez conducted an announced Pre-licensing for a Large Family Child Care Home. Applicant has relocated from her prior location license 434408470 and wants to open a Large Family Child Care Home at this new location. LPA met with Applicant, Heather Wood and explained the purpose of today's inspection. The Applicant rents the home and resides with Jeffrey Wright and her two minor children. Applicant will provide an affidavit to parents that she does not carry insurance until she transfers her current policy to cover this new location. Applicant plans to watch children 0 to 3 years old. The hours of operation are Monday through Friday 7:30AM to 5:30PM.

LPA toured the indoor and outdoor areas of the home during today's inspection:
In Use / On Limits Areas: Living Room, dining room, kitchen, barricaded portion of hallway, 1 small bedrooms off of the hallway and closest to the Living Room. and patio and back yard excluding the left and right sides of the home (barricaded). Off Limit Area: Master bedroom, master bathroom, laundry room, bedroom, hall bathroom, and garage . Outdoors: Back yard and patio is available for the children to use with the exception of the barricaded right and left sides of the back yard..

Fire drills are to be conducted are every 6 months. Applicant will maintain a current children's' roster. The Licensee has a working telephone in the home. LPA observed sufficient materials, toys, and play equipment for the day care children. The home is orderly, and safe for the day care children.

LPA observed a fully charged 3A40BC fire extinguisher in the kitchen. There are working smoke & carbon monoxide detectors in the home. LPA did not observe any bodies of water on the immediate property. The Applicant understands that all pools, spas, hot tubs, fish ponds, or similar bodies of water shall be covered or fenced as specified in Title 22 regulations to be inaccessible to children. Applicant states that there are no weapons or firearms in the home. All detergents, cleaning compounds, other similar items and poisons are out of reach in the laundry room, and are inaccessible to children.

REPORT CONTINUED ON THE FOLLOWING PAGE (PAGE #2 - REPORT DATED 08/08/2023:
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Pietro Hernandez
LICENSING EVALUATOR SIGNATURE: DATE: 08/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/08/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3
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: WOOD, HEATHER
FACILITY NUMBER: 434417364
VISIT DATE: 08/08/2023
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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) or (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.


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, 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 the Applicant. Applicant understands that she must be present in the home at least 80 percent of the hours the day care is in operation and ensure that the children are supervised at all times. The Applicant understands her capacity options. The Applicant states that she does transport children and understands that children cannot be left in parked vehicles unattended at any time. Applicant understands that children's personal rights should not be violated; including no corporal punishment. Isolation of sick child, requirements for reporting suspected child abuse, unusual incidents/injuries, heat-related illnesses, and requirements for assistant/substitute were also discussed.
LPA informed Applicant that Licensing forms and Title 22 regulations, can be obtained through the internet at www.ccld.ca.gov

LPA reviewed the pre licensing packet with the Applicant.

LPA discussed the Individual Infant Sleeping plan and form 9227 with the Applicant.
Website for resource information:
http://www.cdss.ca.gov/inforesources/Community-Care/Self-Assessment-Guides-and-Key-Indicator-Tools/Quarterly-Updates

LPA also provided the e-mail address for the advocates in order to be added to the quarterly newsletter mailing list, [email protected]
REPORT CONTINUED ON THE FOLLOWING PAGE (PAGE #3 - REPORT DATED 08/08/2023
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Pietro Hernandez
LICENSING EVALUATOR SIGNATURE:

DATE: 08/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2023
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-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: WOOD, HEATHER
FACILITY NUMBER: 434417364
VISIT DATE: 08/08/2023
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Applicant does have current Mandated Reporter Certificate and will expire on 5/18/24. LPA discussed Senate Bill 792, Assembly Bill (AB) 1207 (Mandated Child Abuse Reporting Training) which is required training that began on January 1, 2018 and requires renewal every two years, AB 633 was discussed with applicant Licensing forms, Title 22 regulations, can be obtained through the internet at www.ccld.ca.gov. Mandated Reported Training can be accessed at www.mandatedreporterca.com.
Licensee has a current CPR and First Aid card that expires 06/30/24.

On this date, 06/22/2023, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

Applicant was informed of the MyChildCarePlan.org site, 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.

Applicant understands that the license is to be reviewed by Management prior to licensing approval.



Upon the issuance of Type A citations, a copy of the Facility Evaluation Report LIC809 has to be posted on the wall and a copy to be given to all parents of currently and newly enrolled children for next 12 months. In addition, copy of LIC9224 Statement Acknowledging Receipt of Licensing Reports need to be signed and kept in child files.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-carelicensing/subscribe and select the Child Care option to receive email communication.

Exit interview conducted and report was reviewed with the Applicant, Heather Wood.

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Pietro Hernandez
LICENSING EVALUATOR SIGNATURE:

DATE: 08/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2023
LIC809 (FAS) - (06/04)
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