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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434417087
Report Date: 05/17/2023
Date Signed: 05/17/2023 11:23:55 AM

Document Has Been Signed on 05/17/2023 11:23 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-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:MARTINS VIDIGAL, FERNANDAFACILITY NUMBER:
434417087
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
05/17/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:05 AM
MET WITH:Fernanda MartinsTIME COMPLETED:
12:10 PM
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On May 17, 2023 Licensing Program Analyst (LPA) Harsimran Kaur met with applicant Fernanda Martins, for an announced pre-licensing inspection. The Applicant rents this single family - 3 bedrooms and two bathrooms home. The home resident is applicant and her partner. Licensee's partners owns this house. Days and operations are Monday – Sunday 7 days a week from 6:00 AM – 12:00 PM.

LPA and the Applicant inspected the entire home for Health and Safety Hazards. The house has 3 rooms. Daycare areas are living room, dining room, bathroom, 2 bedrooms, and backyard. Off-limit areas- master bedroom, and garage. Per Applicants, all toxic or dangerous chemicals are stored in a cabinet in the kitchen in the off-limit area, making them inaccessible to children.

Per Applicant, there are no firearms, weapons, or pets in the home. The isolation area for sick/ill children will be dining area. The house has multiple smoke alarms & carbon monoxide combination detectors. There are sufficient age-appropriate toys, furniture, and napping equipment in the daycare. The Applicant stated that the facility would be providing breakfast, lunch, morning, and afternoon snacks for children. LPA advised the Applicant to conduct an emergency drill once every six months and document the exercises. The Applicant was informed that NO baby walkers, exer-saucers, jumpers, bouncers, and any similar items to be used for children in care and shall be made inaccessible. LPA also reminded the Applicant that smoking is prohibited at the daycare.
Applicant has wall mounted hearter in living room which is completely shut off.

Posting Parent's Rights and the Emergency Disaster Plan was reviewed with the Applicant during the inspection. Records to be maintained were consulted and reviewed with the Applicant. The Applicant was informed to obtain a copy of regulations and current licensing forms through the Department's website at www.ccld.ca.gov. LPA also reminded the Applicant of the Family Child Care Home License's responsibilities and Reporting requirements. The Applicant was advised to post the License when they received it. Applicant CPR expires on 02/02/2024. Mandated expires on 02/2024.
SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Harsimran Kaur
LICENSING EVALUATOR SIGNATURE: DATE: 05/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/17/2023
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: MARTINS VIDIGAL, FERNANDA
FACILITY NUMBER: 434417087
VISIT DATE: 05/17/2023
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Applicant stated that the form of discipline to be used are talking and redirecting the children. Applicant understands that children's personal rights should not be violated; including no corporal punishment. Applicant stated that he understands that the children have personal rights that cannot be waived or abridged regardless of consent or authorization from the child’s authorized representative

The Applicant was informed that all adults 18 years and older living in the home, helper, or assistant must have fingerprint clearance associated with the facility. Failure to do so could result in an immediate civil penalty of $100.00 each day. LPA discussed the safe sleep regulations with the Applicant and discussed the Child Care Licensing Safe Sleep webpage https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed the Applicant 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.

Incidental Medical Services – IMS. For IMS information, see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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

The Applicant was informed about the Provider Information Notices (PINs) on the CCLD website and the sign-up process. The Applicant was also reminded of Mandated Reporter Online Training for Child Care Providers (AB 1207) and the additional General Training, and both are available on www.mandatedreporteca.com. The Applicant was informed that as of September 1, 2016, a person may not be employed or volunteer at a child care facility unless he or she has been immunized against influenza, pertussis, and measles or qualifies for an exemption pursuant to Health and Safety code 1596.7995 and 1597.662.

Based on today's inspection, LPA advised applicant that a small Family Child Care Home license will be approved pending on Licensing Management final review and approval.
SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Harsimran Kaur
LICENSING EVALUATOR SIGNATURE:

DATE: 05/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/17/2023
LIC809 (FAS) - (06/04)
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