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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434417087
Report Date: 04/18/2024
Date Signed: 04/18/2024 10:21:42 AM

Document Has Been Signed on 04/18/2024 10:21 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:MARTINS VIDIGAL, FERNANDAFACILITY NUMBER:
434417087
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 6CENSUS: 2DATE:
04/18/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:05 AM
MET WITH:Fernanda Martins VidigalTIME VISIT/
INSPECTION COMPLETED:
10:45 AM
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Licensing Program Analyst(LPA), Mandeep Kaur conducted an unannounced annual inspection. LPA met with Licensee Fernanda Martins Vidigal and explained the reason for the inspection. Present during
today's inspection were Licensee, two children and no infant age children were present.

The hours of operation are Monday through Friday 7:30 AM to 6PM. Licensee is advised to submit the LIC279(Application for Family Child Care Home-updated) to licensing in order to update the hours of operations. There is a board to post required postings, such as license and notification of parent's rights. LPA toured the inside and outside of the home with Licensee. The off-limits areas inside are Master bedroom, Tenant/landlord Bedroom and outside off limit areas are Garage and backyard. Disinfectant and cleaning supplies were inaccessible to children. LPA reminded Licensee that anything sharp or states to keep out of reach of children, such as blades or razors need to be inaccessible.

There are toys and equipment for children. Licensee stated that the facility provides breakfast, lunch, afternoon snack and dinner for children. LPA discussed the Healthy Beverages Requirements in child care (AB2084) with licensee. There is a fully charged fire extinguisher, smoke detector, and carbon monoxide detector. The last fire/disaster drill was conducted on 11/20/2023. Licensee stated that there are no weapons, such as firearm, stored in the home.

The side patio and way to second exit is used for outside play and fully fenced.

A copy of the facility roster was obtained. Two (2) children's files were reviewed during today's inspection. The records reviewed include but not limited to immunization records and notification of parent's rights. LPA also reviewed sleep log and the LIC 9227.

Continuation on next pages:
SUPERVISORS NAME: Belinda Devall
LICENSING EVALUATOR NAME: Mandeep Kaur
LICENSING EVALUATOR SIGNATURE: DATE: 04/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/18/2024
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 3
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: MARTINS VIDIGAL, FERNANDA
FACILITY NUMBER: 434417087
VISIT DATE: 04/18/2024
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-------------CONTINUATION OF 809 DATED 04/18/2024 PAGE 1-------------

Licensee completed the Mandated Reporter training on 02/08/2024. Licensee has a valid CPR/1st Aid, which
expires on 02/2026.

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.

Incidental Medical Services (IMS) policy was discussed. 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/.

The adults 18 and over living in the home are Licensee and her two adult children. All adults have cleared
criminal record and child abuse index. 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.

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, the Licensee, Fernanda Martins Vidigal confirmed that there are no Registered Sex
Offenders living in the facility and LPA completed the RSO profile in FAS.

Continuation on page 3:
SUPERVISORS NAME: Belinda Devall
LICENSING EVALUATOR NAME: Mandeep Kaur
LICENSING EVALUATOR SIGNATURE:

DATE: 04/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2024
LIC809 (FAS) - (06/04)
Page: 2 of 3
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: MARTINS VIDIGAL, FERNANDA
FACILITY NUMBER: 434417087
VISIT DATE: 04/18/2024
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-------------CONTINUATION OF 809 DATED 04/18/2024 PAGE 2-------------

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.

As a result of this inspection, No citation was issued. Exit interview conducted and report was
reviewed with Licensee, Fernanda Martins Vidigal. A notice of site visit has been issued and must remain posted for 30 days.
SUPERVISORS NAME: Belinda Devall
LICENSING EVALUATOR NAME: Mandeep Kaur
LICENSING EVALUATOR SIGNATURE:

DATE: 04/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2024
LIC809 (FAS) - (06/04)
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