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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 430757125
Report Date: 05/08/2024
Date Signed: 05/08/2024 04:58:51 PM

Document Has Been Signed on 05/08/2024 04:58 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:CRUZ, GUADALUPEFACILITY NUMBER:
430757125
ADMINISTRATOR/
DIRECTOR:		CRUZ, GUADALUPEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 225-2941
CITY:SAN JOSESTATE: CAZIP CODE:
95121
CAPACITY: 14TOTAL ENROLLED CHILDREN: 11CENSUS: 8DATE:
05/08/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:35 AM
MET WITH:Guadalupe CruzTIME VISIT/
INSPECTION COMPLETED:
12:45 PM
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On 05/08/2024 at 9:35am, Licensing Program Analyst (LPA), Farida Raja, conducted an unannounced annual/random inspection. LPA was granted access to the home by Licensee's daughter/assistant, Sarai Cruz, and explained the nature of today’s inspection. Present in the home were licensee, daughter and 8 children including 3 infants and 5 preschool age. Licensee was operating within the ratio and capacity requirements of the license. Days and hours of operation are Monday to Friday, 6:00 am to 6:00 pm. Licensee provided and updated Application for Family Child Care Home (LIC 279) during today's inspection. LPA did not observe required postings in the family home. Licensee stated that the postings had been removed during renovation and they forgot to put them back. LPA informed Licensee to have required postings near the front entrance so that it is visible to parents/ authorized representatives. LPA provided Licensee with a copy of the Entrance Checklist for Family Child Care Homes (LIC 126) during today's inspection. The adults that reside in the home are licensee and spouse.

LPA toured the indoor areas of the home during today's inspection. Licensee has a working telephone in the home (408-250-4075). LPA observed sufficient materials, toys, and play equipment for the day care children. Tables, chairs, play yards, book shelves and feeding chairs are in good condition.The home has central heating/cooling and ventilation for comfort of children. The home is single story. Off limit areas inside the home: living room, additional room attached to the family room, master bedroom, master bathroom, two bedrooms, closet, kitchen, pantry and attached garage. On limit areas include the family room, dining area and one bathroom. Licensee stated that the entire backyard is off limits to children. Licensee will submit an updated facility sketch (LIC 999) to LPA indicating the on and off limit areas. Licensee stated that there are no bodies of water in the backyard. LPA observed that the bathroom used by children was in operating condition. Toilets and faucet are clean and operable.

LPA observed a fully charged fire extinguisher (3A40BC) in the garage and working smoke/carbon monoxide detectors. Licensee states that she does not have any weapons or pets in the home.

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SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Farida Raja
LICENSING EVALUATOR SIGNATURE: DATE: 05/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/08/2024
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: CRUZ, GUADALUPE
FACILITY NUMBER: 430757125
VISIT DATE: 05/08/2024
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 All detergents, cleaning compounds, poisons, medications, sharp objects and other similar items were observed to be stored in the garage 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 and refilled using store bought water bottles/gallons. Licensee states that she provides breakfast, lunch and snacks to the children in care. Licensee states that a child will be isolated in the living 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 04/19/2024. LPA obtained copy of children's roster.

Children file review was completed and found to be current and up to date. Five (5) random children’s files were reviewed during today's inspection. Licensee has liability insurance through DC Insurance Services and LPA verified valid coverage. LPA reviewed three (3) infant's file and the files were complete with the required forms. 15 minute nap check log was observed for two infants (C1 and C3). Licensee stated that the third infant (C2) just started and has not napped at the facility yet. LPA observed three pack and plays with toys and blankets inside them. Licensee stated that they remove all items when children are placed to sleep. LPA did not observe any infants napping in the pack and plays during today's inspection. LPA reminded Licensee about the safe sleep regulations including having cribs and play yards free of all loose article and objects when infants are placed inside to nap. LPA observed a swing in the family room. LPA reminded Licensee that infants are not allowed to fall asleep inside the swing.

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. 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: 05/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2024
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: CRUZ, GUADALUPE
FACILITY NUMBER: 430757125
VISIT DATE: 05/08/2024
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Two (2) staff files were reviewed. 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 and assistant have current Pediatric CPR/First Aid certification that expires on 07/30/2024. Licensee has the required immunization's for measles, pertussis and a statement declining influenza. Assistant is missing proof of immunization for pertussis. Assistant stated that she obtained the vaccine but is no longer with Kaiser and unable to access those records. Assistant will email proof of Tdap immunity or immunization to LPA. Licensee and assistant have Mandated Reporter Training on file which expires on 9/19/2024.

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 the Licensee and she understands that she must be present in the home during 80% of the operating hours of the day care and ensure that the children are supervised at all times.

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.

Licensee is encouraged to visit the Department’s website at https://cdss.ca.gov/inforesources/child-care-licensing to access general updates, resources for providers, regulations, adoptions of new laws, pay annual fees etc.

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

DATE: 05/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2024
LIC809 (FAS) - (06/04)
Page: 3 of 4
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: CRUZ, GUADALUPE
FACILITY NUMBER: 430757125
VISIT DATE: 05/08/2024
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Incidental Medical Services (IMS) policy was discussed. Licensee stated that she is not administering medication to children 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/.

Licensees stated that she does not transport children. 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.

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 inspectionprocess@dss.ca.gov. 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.

Licensee will submit an updated Emergency Disaster Plan for Family Child Care Homes (LIC 610A) along with relocation letters to LPA by 05/22/2024.

One Technical Violation was issued as a result of today's inspection.

Exit interview conducted and report was reviewed with the licensee, Guadalupe Cruz.

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: 05/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2024
LIC809 (FAS) - (06/04)
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