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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434400382
Report Date: 02/12/2025
Date Signed: 02/13/2025 08:39:50 AM

Document Has Been Signed on 02/13/2025 08:39 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:YWCA DAVIDSONFACILITY NUMBER:
434400382
ADMINISTRATOR/
DIRECTOR:		RODRIGUEZ, JEANINEFACILITY TYPE:
830
ADDRESS:350 SOUTH THIRD STREETTELEPHONE:
(408) 295-4011
CITY:SAN JOSESTATE: CAZIP CODE:
95112
CAPACITY: 10TOTAL ENROLLED CHILDREN: 6CENSUS: 4DATE:
02/12/2025
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:50 AM
MET WITH:Lucille Gabriel/Betty RoblesTIME VISIT/
INSPECTION COMPLETED:
12:00 PM
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Licensing Program Analysts(LPAs)Anna Morales and Marilou Monico conducted a unannounced Case Management inspection. LPAs were met by Director Betty Robles and Executive Director Lucille Gabriel. An application was submitted to Community Care Licensing (CCL) to increase the capacity of the Infant license from 10 to 22 children. Hours of operation will be Monday- Friday, 7:00 AM -6:00 PM, ages 6 weeks to 24 months

During the today's inspection, LPAs measured the two infant classrooms and the Infant Outdoor Playground:

Indoor Measurements
Younger Infant Classroom:15 x 23.33 = 349.95 minus 7.34 (encumbered space)=342.61
Older Infant Classroom: 25.42 x 20.58 = 523.14 minus 37.19 (encumbered space)=485.95
TOTAL INFANT INDOOR SPACE: 828.56 divided by 35 sq. ft.= 23 infants

Outdoor Measurements
Infant Playground:
49.00 x 37.00 =1,813.00 - 16.00 (encumbered space)= 1,797.00
TOTAL OUTDOOR SPACE: 1,797.00 divided by 75. sq. ft. = 23 infants

Continue on LIC809C..................................
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Anna Morales
LICENSING EVALUATOR SIGNATURE: DATE: 02/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/12/2025
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 2
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: YWCA DAVIDSON
FACILITY NUMBER: 434400382
VISIT DATE: 02/12/2025
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LPAs observed two toilets, two sinks, 12 chairs, 2 tables, 40 cubbies, 8 cribs and 12 cots. There is a bathroom for staff in the Older Infant classroom/hallway. Sick children will use the staff bathroom if needed and will be accompanied by a staff member. Sick children will be isolated in the Office and isolation equipment will be provided. There is a diaper changing table within arm's reach of a sink in the infant bathroom.

LPAs observed age appropriate furnishings, toys and playground equipment. The Infant playground has absorbent material underneath the climbing equipment and there is a patio cover for shade. LPAs observed fully charged fire extinguishers and working smoke/carbon monoxide detectors. Breakfast, lunch and snacks will be provided by the facility. There is a kitchen located adjacent to the Older Infant classroom for food preparation.

LPAs observed that there was no sound proof partition between the crib area and the activity area in the Younger Infant classroom.

The following items to be completed prior to licensure:
1. Place a partition that is at least four feet high and constructed of sound proof material and shall be designed to minimize the risk of injury to infants.
2. Revise the fire clearance from 22 infants to 23 infants
2. Manager's review and approval.


SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Anna Morales
LICENSING EVALUATOR SIGNATURE:

DATE: 02/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2025
LIC809 (FAS) - (06/04)
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