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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434416705
Report Date: 02/06/2025
Date Signed: 02/06/2025 03:43:58 PM

Document Has Been Signed on 02/06/2025 03:43 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:MARTINEZ, JOANNAFACILITY NUMBER:
434416705
ADMINISTRATOR/
DIRECTOR:		JOANNA, MARTINEZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 337-5733
CITY:GILROYSTATE: CAZIP CODE:
95020
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 7DATE:
02/06/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:15 PM
MET WITH:Martinez, JoannaTIME VISIT/
INSPECTION COMPLETED:
03:50 PM
NARRATIVE
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On 2/6/2025, at 2:15 PM, Licensing Program Analyst (LPA) Liridon Fici (Doni) arrived unannounced to conduct an Annual inspection and was greeted by Licensee, Martinez, Joanna. LPA also informed Licensee the purpose of today’s visit.

During visit, there were two (2) staff and eight (8) child present. Licensee stated that her, her husband, her mom are the adults residing at the home. Licensee stated she has two (2) minor children also living in the home. All are fingerprint cleared and associated to the facility. LPA observed two (2) children under 2 years and six (6) children over 2 years old; A review of children roster indicated (2 infants).

The day care is located in the kids room of the house. Parents will enter from the front of the house. The home has no stairs going up to the second floor. Days and hours of operation are Monday - Friday from 6:00 AM to 5:00 PM. LPA reviewed Fire/Disaster drill log during today's inspection was conducted on 10/18/2024.

LPA toured the indoor and outdoor areas of the home during today's inspection. The Licensee’s has a working land line and cell phones in the home. LPA observed sufficient materials, toys, and play equipment for the day care children. The home is clean, orderly, and safe for the day care children. The backyard is enclosed by a fence. Off limit areas inside Licensee's home: Master bedroom, bedroom 2, and laundry room/ garage. Off limits to the outside home include: front yard, and the right side of the backyard which is fenced...
Continue on Lic809-C page 2...
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Liridon Fici
LICENSING EVALUATOR SIGNATURE: DATE: 02/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/06/2025
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: MARTINEZ, JOANNA
FACILITY NUMBER: 434416705
VISIT DATE: 02/06/2025
NARRATIVE
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LPA toured the backyard area and observed the backyard area is adequately fenced and there are no bodies of water. There is a designated area in the living room area where the front door is located where child(ren) can be isolated if exhibiting any signs of illness until the child's parent(s) pick them up.

Licensee provides breakfast along with AM snacks, and lunch. On occasion, licensee will accept outside foods from parents on events such as Birthdays, Valentine's day, Christmas, and Thanksgiving. Licensee will prepare and cook meals for children at home. LPA observed a first aid kit in the day care. Staff stated that nobody smokes, and she understands that smoking is prohibited in the day care. LPA observed a fully charged 3A4BC fire extinguisher last time serviced on 1/8/2025, with working smoke and carbon monoxide detectors that are interconnected. The Licensee stated that there are no weapons in the home. All detergents, cleaning compounds, medications, and other similar items are stored inaccessible to children.

Licensee and Staff files were reviewed for the following records: Employee Rights (LIC9052), Statement Acknowledging Requirement to report Child Abuse (LIC9108), and Immunization Record showing immunity to measles (MMR), pertussis (Tdap), and influenza (or statement declining influenza). Licensee has a current Mandated Reporter Training and was conducted on 1/30/2025. Licensee has current Pediatric CPR/FIRST AID that was conducted on 12/13/2022. LPA informed Licensee that Mandated reporting and First aid/CPR is mandatory and should be renewed every 2 years.



LPA will continue the annual inspection at a later time.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted with Licensee, and a copy of this review was reviewed and provided along with appeal rights.

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Liridon Fici
LICENSING EVALUATOR SIGNATURE:

DATE: 02/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2025
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 02/06/2025 03:43 PM - It Cannot Be Edited


Created By: Liridon Fici On 02/06/2025 at 03:20 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: MARTINEZ, JOANNA
FACILITY NUMBER: 434416705

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/06/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, and record review, the licensee did not comply with the section cited above by not re-training and maintaining current Mandated reporters training for Staff 2 (S2) which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 02/13/2025
Plan of Correction
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Licensee agreed to have S2 complete mandated reporters training and to submit to CCL by POC due date.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Gladys Kuizon
LICENSING EVALUATOR NAME:Liridon Fici
LICENSING EVALUATOR SIGNATURE:
DATE: 02/06/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/06/2025


LIC809 (FAS) - (06/04)
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