430700096-11-2-2022-07-CC-JGSS-CKSUWV-20221102155723

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 430700096
Report Date: 11/02/2022
Date Signed: 11/02/2022 03:57:31 PM

Document Has Been Signed on 11/02/2022 03:57 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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME:	DISCOVERY PARENT CHILD PRESCHOOL		FACILITY NUMBER:	430700096
ADMINISTRATOR:	SALLY STARZ		FACILITY TYPE:	850
ADDRESS:	1919 GUNSTON WAY		TELEPHONE:	(408) 377-5390
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95124
CAPACITY:	28	CENSUS: 7	DATE:	11/02/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:40 AM
MET WITH:	Erica Shirley-Chubbic		TIME COMPLETED:	04:10 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analyst (LPA), James Santos conducted an unannounced Required 1 Year inspection at the Facility today and met with Director, Erica Shirley-Chubbic. The center is a Parent Co-Op Program. The operation hours are Mondays: 8:45 - 11:30am and 12:15-3pm; Tuesdays: 12:15-3pm; Wednesdays: 8:45-11:30am; Thursdays: 12:15-3pm; and Fridays: 8:45 to 11:30am and 12:15-3pm. LPA toured the Facility inside and outside with the Director. All classrooms were observed to be clean and well maintained. Furniture and equipment were observed to be in good condition. There are age appropriate toys available for children. Fire extinguishers, fire alarm system, smoke and carbon monoxide detectors were observed in the classrooms. There are solid waste containers with tight-fitting lids in each classrooms. The children's bathroom was observed to be clean and sanitary. Chemicals and cleaning solutions are secured and inaccessible to children. Per Director, there are no weapons or firearms on the premises. Snacks are provided in the morning and in the afternoon. The children bring their own drinking water, and the center also provides additional drinking water through a water container dispenser and drinking fountains outside in the playground area. The outside playground area is surrounded by appropriate fencing and were observed to be safe and free of hazards. The outdoor play equipment are in good condition and the surface area has sufficient resilient materials. There are no bodies of water observed. *Continued on next page*

SUPERVISOR'S NAME: Joel Segura	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: James G Santos	TELEPHONE: (408) 334-8556
LICENSING EVALUATOR SIGNATURE:	DATE: 11/02/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/02/2022

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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: DISCOVERY PARENT CHILD PRESCHOOL	FACILITY NUMBER: 430700096
	VISIT DATE: 11/02/2022

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

LPA reviewed ten (10) children's records which include Admission Agreement, Identification and Emergency Contact, Consent for Emergency Medical Treatment form, receipt of Parent Rights Notice, Personal Rights Notice, Medical Assessment and Immunization and care plan. LPA reviewed two (2) staff records which include Immunization (Measles, Pertussis, and Flu) record, TB Clearance, CPR/First Aid and Mandated Reported Training, Curriculums and qualifications.

Per review of record, the center conducts emergency disaster drills monthly.

Incidental Medical Services (IMS) policy was discussed. Per Director, they currently do not administer medications. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes 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.

Director was reminded that all adults 18 and over, 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 Child Care Center. 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.

No deficiencies cited. Exit interview conducted. Report was reviewed and a copy was provided to Director, Erica Shirley-Chubbic.

NOTICE OF SITE VISIT WAS ISSUED AND MUST REMAIN POSTED FOR 30 DAYS.

SUPERVISOR'S NAME: Joel Segura	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: James G Santos	TELEPHONE: (408) 334-8556
LICENSING EVALUATOR SIGNATURE:	DATE: 11/02/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/02/2022

LIC809 (FAS) - (06/04)

Page: 2 of 2