430701148-9-27-2024-07-CC-MKAR-D9HR8W-20240927124835

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 430701148
Report Date: 09/27/2024
Date Signed: 09/27/2024 12:49:10 PM

Document Has Been Signed on 09/27/2024 12:49 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:	SOUTH PENINSULA HEBREW DAY SCHOOL		FACILITY NUMBER:	430701148
ADMINISTRATOR:	HANG DANG		FACILITY TYPE:	850
ADDRESS:	1030 ASTORIA DR		TELEPHONE:	(408) 738-3060
CITY:	SUNNYVALE	STATE: CA	ZIP CODE:	94087
CAPACITY:	135	CENSUS: 41	DATE:	09/27/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	08:43 AM
MET WITH:	Perry Tirschwell and Danielle Perrine		TIME COMPLETED:	12:30 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	Licensing Program Analysts (LPAs) Mandeep Kaur and Andy Yang met with Head of school, Perry Tirschwell and Coordinator, Danielle Perrine for an unannounced Annual/Random inspection. The purpose of today's inspection was explained with Head of school and coordinator. Facility's License, Notification of Parents’ Right 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's operating hours are Monday through Friday from 08:00 AM to 5:30 PM. The facility is licensed to serve children ages 18 months to entry into first grade in Rooms: #1, #2, #3 #4,#5,#6,#7 and #8. LPAs toured the indoor and outdoor areas with Head of school. LPAs observed that the teacher-child ratio was in compliance. Fire drill was conducted on September 17, 2024. The facility has current children's roster and a copy was provided to LPAs during the inspection. Cleaning products, disinfectants, sharp objects were stored inaccessible to children. Furniture and equipment were observed to be age appropriate and in good condition. The facility is clean. The bathrooms for children and staff are clean, sanitary, and operable. Head of School stated that the center has a third party cleaning service that comes and clean the facility after daycare hours and day crew cleans during the day. The center provides morning snacks, lunch, and afternoon snacks to the children. There is a kitchen at the facility for food preparation. The kitchen is equipped with refrigerators, stove, oven, dishwasher, storage space for food, and a sink with hot and cold running water. Drinking water is available for the children indoor via filtered tap water and individual water bottles. LPAs observed trash cans with tight fitting covers for the disposable of solid waste. The facility has fire extinguishers and working smoke and carbon monoxide detectors. *Continuation on next pages:*

SUPERVISOR'S NAME: Belinda Devall	TELEPHONE: (408) 598-5501
LICENSING EVALUATOR NAME: Mandeep Kaur	TELEPHONE: 408-334-8320
LICENSING EVALUATOR SIGNATURE:	DATE: 09/27/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2024

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: SOUTH PENINSULA HEBREW DAY SCHOOL	FACILITY NUMBER: 430701148
	VISIT DATE: 09/27/2024

NARRATIVE

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The playground is surrounded with appropriate fencing and the outdoor surfaces are safe. Shade is provided by canopies. Drinking water is readily available for the children outdoor via filtered tap water and individual water bottles. LPAs observed climbing structures with resilient material under and around the structures. There were no bodies of water observed. Head of school stated that there are no weapons or firearms on the premises.

LPAs reviewed 6 random children's files. Children records reviewed include Admission Agreement, Identification and Emergency Information, Consent for Emergency Medical Treatment, Physician's Report, TB test, Immunizations, Parent Right's Receipt, Personal Rights, and Health History.

LPAs reviewed 6 staff files. Staff records reviewed include Employee Rights, Statement Acknowledging
Requirement to Report Child Abuse, Health Screening Report with TB Clearance, Immunizations (Measles,
Pertussis, and Influenza) and required training. LPAs reminded Head of school and coordinator that the Mandated Reporter Training shall be renewed by all staff every two years. At least one staff member present during the inspection has current Pediatric CPR/First Aid certifications.

This facility provides Incidental Medical Services – IMS. LPAs 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/resources/child-care-centers/.

Coordinator was reminded that all adults 18 and over, 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 Child Care Center. 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.
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SUPERVISOR'S NAME: Belinda Devall	TELEPHONE: (408) 598-5501
LICENSING EVALUATOR NAME: Mandeep Kaur	TELEPHONE: 408-334-8320
LICENSING EVALUATOR SIGNATURE:	DATE: 09/27/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2024

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: SOUTH PENINSULA HEBREW DAY SCHOOL	FACILITY NUMBER: 430701148
	VISIT DATE: 09/27/2024

NARRATIVE

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Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1- CCP).

LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

Coordinator 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&R's) throughout California.

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.

No deficiency is issued during today's inspection.

Exit interview conducted and report was reviewed with Coordinator, Danielle Perrine.

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

SUPERVISOR'S NAME: Belinda Devall	TELEPHONE: (408) 598-5501
LICENSING EVALUATOR NAME: Mandeep Kaur	TELEPHONE: 408-334-8320
LICENSING EVALUATOR SIGNATURE:	DATE: 09/27/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2024

LIC809 (FAS) - (06/04)

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