430703695-10-20-2021-07-CC-JCRZ-C7TUZZ-20211015160222

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 430703695
Report Date: 10/15/2021
Date Signed: 10/20/2021 09:13:53 AM

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:	SJB - SAN JUAN BAUTISTA CHILD DEVELOPMENT CENTER		FACILITY NUMBER:	430703695
ADMINISTRATOR:	ANN-MARIE LEMMERMAN		FACILITY TYPE:	850
ADDRESS:	1945 TERILYN AVENUE		TELEPHONE:	(408) 259-4796
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95122
CAPACITY:	231	CENSUS: 60	DATE:	10/15/2021
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	10:45 AM
MET WITH:	Annie Lemmerman		TIME COMPLETED:	04:25 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) Janette Cruz and Mel Matos conducted an unannounced case management inspection in response to a request for change of capacity from 231 to 176 (preschool from 195 to 128 children and toddler option from 36 to 48 children). LPAs met with Annie Lemmerman, Director, and explained to her purpose of today’s inspection. The Facility received a fire safety inspection approval from the San Jose Fire Department for the change of capacity on 09/30/2021. LPAs toured and measured the indoor and outdoor areas of the Facility during today's inspection. Preschool Rooms / Building 1: Room P1 29.250 x 27.417= 801.947 minus 4.250 x 1.167 = 4.959 (encumbered space) = 796.988 Room P2 27.500 x 29.583 = 813.532 minus - (4.250 x 1.167) x 2 = 9.919 (encumbered space = 803.613 Room P3 27.417 x 29.417 = 806.526 minus (4.250 x 1.167) x 2 = 9.919 (encumbered space = 796.607 Room P4 32.000 x 19.083 = 610.656 minus - (4.250 x 1.167) = 4.959 (encumbered space = 575.946 Room P6 (29.667 x 16.333= 484.551) +(24.583 x 15.167 = 372.850) minus (4.250 x 1.167) x 2.000 = 9.919 (encumbered space) = 847.482 Room P7 34.583 x 29.583 =1023.068 minus - (8.583 x 1.167 =10.016 + 10.167 x 12.000 =120.192 - encumbered space) =892.86 *TOTAL PRESCHOOL INDOOR SPACE: 4713.496 sq. ft. divided by 35 = 134 children.* Toddler Option Rooms - Building 1: Room 3A / 3B 39.417 x 20.083 = 791,611 - minus 5.000 x 1.167= 5.835 (encumbered space) = 785.776

SUPERVISOR'S NAME: Diana Stephenson	TELEPHONE: (408) 324-2128
LICENSING EVALUATOR NAME: Janette Cruz	TELEPHONE: (408) 334-8312
LICENSING EVALUATOR SIGNATURE:	DATE: 10/15/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2021

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: SJB - SAN JUAN BAUTISTA CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 430703695
	VISIT DATE: 10/15/2021

NARRATIVE

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Toddler Option Rooms - Building 2
Room 1A (13.167 x 17.000 =223.839) +(6.000 x 11.000 = 66.000) = 289.839
Room 1B 24.500 x 18.000 = 441 minus (10.250 x 5.750 = 58.93) +(3.083 x 3.750 =11.561) = 70.491(encumbered space) = 370.59
Room 2A 23.750 x 16.083) x 7.83= 381.971
Room 2B (18.000 x 13.250 = 238.50)+(17.167 x 11= 188.837) = 427.337

Total Toddler Option Space: 2,255.513 sq. ft. divided by 35 = 64 children

There are 11 toilets (165) and 13 sinks (195) available for the preschool children. There are 7 toilets (105) and 8 sinks (120) available for the toddler option children. There is only cold water available in children's sinks. Staff have their own bathrooms which is located in both buildings. There are trash cans with tight-fitting lids located throughout the Facility. There are adequate equipment, supplies and toys for children indoors. Drinking water is provided indoors by water dispensers and water bottles.

LPAs did not observe any fireplace units or wall heater units in the Facility. All Rooms have appropriate lighting, heating, and air conditioning. First aid kits (including touchless thermometers) are stored in the Facility inaccessible to the children. The Facility has working smoke/carbon monoxide detectors and centralized fire alarm system.

Outdoor measurements and information are:
Preschool Playground
97.000 x 42.500 = 4122.50
48.500 x 64.000 = 3104.000
96.000 x 74.250 = 9,456.889

Total Preschool Outdoor Space =16,683.39 sq ft. divided by 75 = 222 children

SUPERVISOR'S NAME: Diana Stephenson	TELEPHONE: (408) 324-2128
LICENSING EVALUATOR NAME: Janette Cruz	TELEPHONE: (408) 334-8312
LICENSING EVALUATOR SIGNATURE:	DATE: 10/15/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2021

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: SJB - SAN JUAN BAUTISTA CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 430703695
	VISIT DATE: 10/15/2021

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Toddler Option Playground
26.500 x 19.667 = 521.175
26.750 x 10.000 = 267.50
45.000 x 42.000 =1890.000

Total Toddler Option Outdoor Space = 2,678.675 sq ft divided by 75 = 35 children

LPAs observed that the toddler and preschool playgrounds are surrounded by appropriate fencing. The preschool playgrounds have climbing structures with sufficient resilient materials (rubber surfacing). There is adequate age appropriate supplies and toys outdoors. Shade is provided by canopies, building overhangs, trees and umbrellas. Drinking water is provided by a water dispensers and water bottles outdoors. LPAs observed no bodies of water.

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 maximum per day/ per person will be assessed if this regulation is violated.

No deficiencies issued during today's inspection

LPAs conducted an exit interview and advised Annie Lemmerman that request for decrease in capacity (128 preschool children and 48 toddler option children) will be approved upon completion of the following items:

1. Licensee must submit a waiver request for the toddler playground along with a copy of daily schedule of playground use.

2. Waiver request for the toddler playground has been received and approved by LPA's manager.

A notice of site visit was given and must remain posted for 30 days.

SUPERVISOR'S NAME: Diana Stephenson	TELEPHONE: (408) 324-2128
LICENSING EVALUATOR NAME: Janette Cruz	TELEPHONE: (408) 334-8312
LICENSING EVALUATOR SIGNATURE:	DATE: 10/15/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2021

LIC809 (FAS) - (06/04)

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