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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 430709429
Report Date: 03/12/2025
Date Signed: 03/13/2025 09:26:19 AM

Document Has Been Signed on 03/13/2025 09:26 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:MCKINLEY STATE PRESCHOOL/HEAD STARTFACILITY NUMBER:
430709429
ADMINISTRATOR/
DIRECTOR:		JENNIFER PAREFACILITY TYPE:
850
ADDRESS:651 MACREDES AVENUETELEPHONE:
(408) 573-4716
CITY:SAN JOSESTATE: CAZIP CODE:
95116
CAPACITY: 144TOTAL ENROLLED CHILDREN: 144CENSUS: 56DATE:
03/12/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:50 AM
MET WITH:Jennifer PareTIME VISIT/
INSPECTION COMPLETED:
11:50 AM
NARRATIVE
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Licensing Program Analysts (LPAs) Anna Morales and Kate Huang conducted a Case Management inspection to follow up on an Unusual Incident that was reported by the facility to Licensing on 02/05/2025. LPAs was greeted by Jennifer Pare, director. LPAs toured the facility, interviewed staff, and reviewed files.

Based on interviews and evidence gathered, it was determined that on 02/05/2025, approximately at 11:15 am a Preschool aged child(C1) was left unattended for approximately 1-2 minutes in the playground outside Classroom Room 5. This poses an immediate risk to the health, safety, and personal rights to children in care.

LPAs informed director that this report dated on 03/12/2025 documents One Type A citation which shall be posted for 30 consecutive days as there is immediate risk to the health, safety, or personal rights of children in care.

Also, LPAs informed the director to provide a copy of this licensing report dated on 03/12/2025 that documents any Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

Exit interview was conducted with the director, Jennifer Pare, and Plan of Corrections were reviewed. A notice of site visit has been issued and must remain posted for 30 days. Appeal Rights Given.

Gladys KuizonTELEPHONE: (510) 566-5850
Linke HuangTELEPHONE: (916) 917-6562
DATE: 03/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/12/2025
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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Document Has Been Signed on 03/13/2025 09:26 AM - It Cannot Be Edited

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: MCKINLEY STATE PRESCHOOL/HEAD START
FACILITY NUMBER: 430709429

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/12/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
03/12/2025
Section Cited
CCR
101229(a)(1)

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Responsibility for Providing Care and Supervision(a)(1) No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation.
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The director has provided their Plan of Correction documents during the time of inspection.
This Deficiency has been Cleared.
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This requirement was not met as evidenced by: A child was left unattended in the playground on February 5th, 2025. This poses an immediate risk to the health, safety, and personal rights to children in care.
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Upon receipt, Director shall post this report and provide copies of this licensing report, have LIC 9224 signed and kept on file, to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. According to AB 633, parents must be provided with this report which contains this Type A deficiency for the next 12 months & copy of the signed acknowledgment form must be kept in each child's file.

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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Gladys KuizonTELEPHONE: (510) 566-5850
Linke HuangTELEPHONE: (916) 917-6562

DATE: 03/12/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/12/2025

LIC809 (FAS) - (06/04)
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