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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 274416771
Report Date: 01/23/2023
Date Signed: 01/23/2023 03:00:08 PM

Document Has Been Signed on 01/23/2023 03:00 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-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:CARROLL, JILLFACILITY NUMBER:
274416771
ADMINISTRATOR:JILL, CARROLLFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 578-9970
CITY:SALINASSTATE: CAZIP CODE:
93908
CAPACITY: 14TOTAL ENROLLED CHILDREN: 2CENSUS: DATE:
01/23/2023
TYPE OF VISIT:OfficeANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Jill CarrollTIME COMPLETED:
03:10 PM
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Licensing Program Analyst (LPA) Joe Macias, and Licensing Program Manager (LPM) Gladys Kuizon, met with Licensee, Jill Carroll, at the San Jose Regional Office today for a scheduled Informal Office Meeting. The purpose of the informal meeting was to discuss violation cited during the January 6, 2023 Prelicensing Inspection.

On January 6, 2023, the Applicant was cited due to unlicensed care. Upon arrival the LPA witnessed unlicensed care being provided, the Applicant was caring for four children ( 1 infant, 3 preschool age) from two different families.

The following items were discussed - understanding and implementation of Title 22 California Code of Regulations.

- Title 22 section 102358 License Exemptions, licensure is required before family child care is provided. Any family day care home providing care for the children of only one family in addition to the operator's own children.
- Title 22 section 102370 Criminal Record Clearance, was also discussed. Prior to the Department issuing a license, the applicant(s) and all adults residing in the home shall obtain a California criminal record clearance or exemption. All individuals subject to a criminal record review shall be fingerprinted and sign a Criminal Record Statement (LIC 508) under penalty of perjury.
- Title 22 section 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, if all of the following conditions are met: No more than three infants are cared for during any time when more than 12 children are being cared for.
- Title 22 section 102421 Child's Records, The licensee shall maintain complete children records.
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Joseph Macias
LICENSING EVALUATOR SIGNATURE: DATE: 01/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/19/2023
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-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: CARROLL, JILL
FACILITY NUMBER: 274416771
VISIT DATE: 01/23/2023
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Licensing Program Manager (LPM) Gladys Kuizon explained the informal meeting and the administrative process. Licensee was advised that continued non-compliance with Title 22 Regulations could result in their license being referred to Community Care Licensing's legal department for review and possible action against the license. Child Care Parent Notification Requirements and Acknowledgement of Receipt of Licensing Reports (LIC9224) was also explained and provided to Licensee during today’s meeting. Licensee understands that this Department will be increasing the monitoring of the facility.
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Joseph Macias
LICENSING EVALUATOR SIGNATURE:

DATE: 01/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2023
LIC809 (FAS) - (06/04)
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