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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434416583
Report Date: 12/03/2024
Date Signed: 12/03/2024 01:24:47 PM

Document Has Been Signed on 12/03/2024 01:24 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 CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:MELESKY, MARAFACILITY NUMBER:
434416583
ADMINISTRATOR/
DIRECTOR:
FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 6CENSUS: 6DATE:
12/03/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:30 AM
MET WITH:Mara MeleskyTIME VISIT/
INSPECTION COMPLETED:
01:30 PM
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Licensing Program Analyst (LPA) Mel Matos met with Mara Melesky, Licensee, for an unannounced Annual/Random & capacity increase inspection. LPA notes that the Licensee resides in the North Park Apartment Home complex facing Baypointe Drive (1st floor). Public parking is available on Baypointe Drive. LPA was granted access to the home by the Licensee. Licensee has been licensed at her current location since July 30, 2024. Licensee was also licensed at a previous location (Facility #: 434416539) from 01/06/2023 to 07/30/2024 and thus has met the one year experience requirement for a capacity increase request. LPA also observed six day care children (3 infants & 3 preschool) and one adult assistant in the home during today's inspection. LPA observed the required postings, including the facility license, near the main day care area of the home. Days and hours of operation are Monday - Friday from 8:00 AM to 5:00 PM. Licensee is the only adult residing in the home. Licensee has a 3 year old daughter also residing in the home.

LPA reviewed a current Child Care Facility Roster and Fire/Disaster drill log during today's inspection. The last fire/disaster drill was completed on November 15, 2024. Licensee states that she does not have liability insurance for the day care and thus issues the Affidavit Regarding Liability Insurance (LIC 282) to all enrolled families. Licensee & her adult assistant has current CPR and First Aid certifications (expiration: 09/07/2026). Licensee & her adult assistant has the required vaccines (MMR, Tdap, & flu - opt out) and is current with their Mandated Reporter Training for Child Care Workers (expiration: 10/02/2026). LPA reviewed six children's files and the files were complete with the required forms and immunization records. LPA reviewed two staff files (Licensee & adult assistant) and the files were complete with the required forms and immunization records.

LPA toured the indoor and outdoor areas of the home during today's inspection. Licensee has a working telephone in the home (#650-722-4823). The home is clean, orderly, (including heating/air conditioning/ventilation), and safe for the day care children. There are safe & age appropriate toys, play equipment, and materials for the children in the home. There are no stairs, fireplace, or wall heater units inside the home. Off limit areas inside the home: one bedroom and one bathroom. Off limit area outside the home: front entrance area. Licensee states that the children utilize the outdoor patio area, located adjacent to the living/dining room, under direct supervision.

LPA observed a fully charged 2A10BC fire extinguisher, working smoke/carbon monoxide detectors, and fenced patio area. There is a swimming pool within the complex that is adequately fenced with a self-latching gate. Licensee states that the swimming pool is only for residents of the complex. Licensee states that she does not have any weapons or pets in the home. All detergents, cleaning compounds, medications, and other similar items are inaccessible to children. Any poisons are locked and inaccessible to the day care children.
SUPERVISORS NAME: Belinda Devall
LICENSING EVALUATOR NAME: Melvin S Matos
LICENSING EVALUATOR SIGNATURE: DATE: 12/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/03/2024
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 CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: MELESKY, MARA
FACILITY NUMBER: 434416583
VISIT DATE: 12/03/2024
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Licensee states that she provides breakfast, lunch, and PM snack for the day care children. Licensee understands that any food brought from home shall be labeled with each child's name and properly stored. Licensee has a first aid kit in the home which includes a touch less thermometer. Licensee understands that smoking is prohibited in the home.

Licensee states that she does not administer any medications to the day care children at this time. Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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: http://www.ada.gov/childqanda.htm

Supervision of children was discussed with the Licensee and she understands that she must be present in the home during day care hours and ensure that the children are supervised at all times. Licensee understands the capacity/ratio options and she understands that she cannot have more than 8 children present in the home without at least one qualified adult present. Licensee states that a child will be isolated in the living room area if necessary due to illness or communicable disease. Licensee states that she does not transport any day care children. Licensee understands that children shall not be left unattended in parked vehicles and that car seats shall only be used for transportation and shall not be used for sleeping.
Mara Melesky, Licensee, was reminded that all adults 18 and over living or working in the home, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with the 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 the 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.

Licensee 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.



To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process

A fire clearance approval from the San Jose Fire Department has not been received as of today's inspection.

Exit interview conducted and report was reviewed with the Licensee, Mara Melesky. No deficiencies issued during today's inspection. A large Family Child Care Home License will be approved upon receipt of the fire inspection approval from the San Jose Fire Department. Notice of site visit issued and must remain posted for 30 days.

SUPERVISORS NAME: Belinda Devall
LICENSING EVALUATOR NAME: Melvin S Matos
LICENSING EVALUATOR SIGNATURE:

DATE: 12/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2024
LIC809 (FAS) - (06/04)
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