430700960-10-6-2021-07-CC-MMOO-C7JVY2-20211006165025

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 430700960
Report Date: 10/06/2021
Date Signed: 10/06/2021 04:50:29 PM

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:	ACTION DAY NURSERY ON MOORPARK		FACILITY NUMBER:	430700960
ADMINISTRATOR:	NORRY, SHAWNA		FACILITY TYPE:	850
ADDRESS:	3030 MOORPARK AVENUE		TELEPHONE:	(408) 247-6972
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95128
CAPACITY:	233	CENSUS: 110	DATE:	10/06/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Brittany Strange		TIME COMPLETED:	03:30 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	#2 Licensing Program Analyst (LPA) Marilou Monico conducted an unannounced Required - 1 Year inspection. LPA met with Site Director, Brittany Strange, and explained the purpose of today's inspection. Facility's License, Notification of Parents’ Rights Poster, Child Car Seat Law, Personal Rights (LIC 613A), Emergency Disaster Plan, Menus, Activity Schedule, and Earthquake Preparedness Checklist were observed to be posted. The center is open Monday through Friday from 07:30 AM to 5:30 PM. Age serve is 2 years to entry into first grade. The preschool program is licensed in Rooms 8 thru 20. LPA toured the indoor and outdoor areas. LPA observed that the facility was operating in compliance with teacher to children ratio requirement. There were no bodies of water observed. Per Site Director, there were no weapons on the premises. Furniture and equipment were observed to be age appropriate and in good condition, free of sharp, loose, or pointed parts. Disinfectants, cleaning solutions, and other items that are dangerous to children were stored inaccessible to children. Restrooms for children to use were observed to be in operating conditions. Outdoor activity spaces are enclosed by fencing and are observed to be free of hazards. LPA observed play equipment were in good condition and areas around the climbing structures have resilient material. Drinking water was readily available to children indoor and outdoor via individual water bottles. Facility provides morning and afternoon snacks and are prepared in the snack room located in Building D. LPA observed that food storage areas were clean. Parents have the option to purchase hot lunch catered to the center from Action Day Primary Plus main kitchen located at 3500 Amber Drive, San Jose, CA 95117. Continuation on next page:

SUPERVISOR'S NAME: Anthony Studebaker	TELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Marilou Monico	TELEPHONE: (408) 334-8549
LICENSING EVALUATOR SIGNATURE:	DATE: 10/06/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/06/2021

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

FACILITY NAME: ACTION DAY NURSERY ON MOORPARK	FACILITY NUMBER: 430700960
	VISIT DATE: 10/06/2021

NARRATIVE

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Foods and beverages were kept protected against contamination and spoilage. Trash cans for solid waste had tight-fitting covers on, and were in good repair. LPA observed working smoke detectors and functioning carbon monoxide detectors.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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.

LPA reviewed sign in and out procedures. Ten children's files and eight staff's files were reviewed. LPA reminded Site Director that the online AB1207 Mandated Reported Training needs to be renewed every two years. Site Director has current certification in Pediatric CPR and First Aid.

A review of staff records during today's inspection indicates that all Facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. LPA reminded Site Director of the applicable civil penalties for those adults who have not received fingerprint clearances, are not associated to the license, and who come in contact with or provide care and supervision to the children. For an initial violation, civil penalty amounts to $100.00 per person per day up to $500.00 per person. For a subsequent violation within a 12-month period, civil penalty amounts to $100.00 per person per day up to $3000.00 per person.

Director's paperwork and copy of children's roster were obtained during the inspection.

As a result of this inspection, there were no deficiencies cited.

A copy of this report was provided to the facility at the conclusion of the inspection.

NOTICE OF SITE VISIT WAS ISSUED. SITE DIRECTOR WAS INFORMED TO POST THE NOTICE IN A VISIBLE LOCATION OF THE DAY CARE FOR A PERIOD OF 30 DAYS.

SUPERVISOR'S NAME: Anthony Studebaker	TELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Marilou Monico	TELEPHONE: (408) 334-8549
LICENSING EVALUATOR SIGNATURE:	DATE: 10/06/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/06/2021

LIC809 (FAS) - (06/04)

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