430709907-9-28-2023-07-CC-FRAA-CW4U7K-20230928152003

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 430709907
Report Date: 09/26/2023
Date Signed: 09/28/2023 03:20:11 PM

Document Has Been Signed on 09/28/2023 03:20 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-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME:	CATALYST KIDS - HAYES		FACILITY NUMBER:	430709907
ADMINISTRATOR:	DIANA RAMOS		FACILITY TYPE:	840
ADDRESS:	5035 POSTON DRIVE		TELEPHONE:	(408) 629-1185
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95136
CAPACITY:	105	CENSUS: 22	DATE:	09/26/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:35 PM
MET WITH:	Diana Hosn		TIME COMPLETED:	05:20 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	On 09/26/2023 at 1:35pm, Licensing Program Analyst (LPA), Farida Raja, met with Director, Diana Hosn, for an unannounced Required 1-Year inspection in the school age program. The facility is licensed to serve children from kindergarten to 12 years in classroom A, classroom B and portable room 1 which are located on the Hayes Elementary School campus. Facility also has a preschool license (#434403619) at this location. Director stated that the preschool program is open but do not have any children enrolled at present. The school age program currently operates Monday through Friday, 6:30 am to 8 am and 1:20 pm to 6 pm. The facility has two waivers on file for electronic sign in/ out and shared outside playground space. The school age program shares the outdoor kindergarten space with Hayes Elementary School's kindergarten class. LPA observed all required posted materials including menus and daily activity schedule in classroom A. Director stated that they are currently using classrooms A and B. LPA observed 2 teachers and 22 children during today's inspection. Facility was in compliance with teacher to children ratio requirement. LPA toured the indoor and outdoor areas of the school age program during today's inspection. The classrooms, children's restrooms, staff restrooms and kitchen were inspected. During today's inspection, LPA observed children engaged in various activities under the supervision of staff. Facility has central heating/cooling for comfort of children. Director states that there are no weapons or firearms on the premises. There is a working telephone at the facility (408-629-1185). Disinfectants and cleaning products were stored inaccessible to the children under the locked kitchen sink. Furniture and equipment were age appropriate and in good condition, free of sharp, loose, or pointed parts. Floors were clean and free from tripping hazards. LPA observed solid waste containers with tight-fitting lids in the rooms. Restrooms and sinks for children were observed to be safe, sanitary, and in working condition. Restroom sinks have only cold running water. Staff use the school bathrooms that can be utilized by sick children if needed. Director stated that medication is in stored in a lock box in the office and LPA observed medication including consent form.. Continued on Page 2

SUPERVISOR'S NAME: Gladys Kuizon	TELEPHONE: (510) 566-5850
LICENSING EVALUATOR NAME: Farida Raja	TELEPHONE: (916) 926-9269
LICENSING EVALUATOR SIGNATURE:	DATE: 09/26/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2023

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-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: CATALYST KIDS - HAYES	FACILITY NUMBER: 430709907
	VISIT DATE: 09/26/2023

NARRATIVE

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LPA observed 3A40BC fire extinguishers in each classroom, working smoke and carbon monoxide detectors, and fire pull stations. The facility has a built-in smoke detector/ fire system. Log shows that the last Fire Drill was conducted on 08/28/2023 which is compliant with the six-month requirement for facilities.

Drinking water is readily available for children in each room and in the outdoor playground area via water pitchers, water cooler and disposable cups. Water lead testing was completed for the facility on 01/22/2022 and no Action Level Exceedances were reported. 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. LPA referred Director to the Department website for lead: Lead Toxicity Prevention and Water Testing Information.

Facility provides breakfast and snacks to school age children. Food storage and preparation area is located in Room B and was observed to be sanitary. Director stated that they are part of the Child and Adult Care Food Program. LPA observed monthly menus posted in the classrooms and in the kitchen. Allergy list was observed posted behind cabinet door in the kitchen area. Foods and beverages were stored safely to prevent contamination and spoilage. All food and beverages that require refrigeration are stored in covered containers with date opened written on them. LPA observed a first aid kit in high cabinet in the kitchen.

Outdoor playground and play equipment was inspected and observed to be fenced in, age appropriate and free of hazards. Areas around and under high climbing equipment and slides were cushioned with tan bark as resilient material to absorbs falls. Shaded rest area is provided by trees. There were no bodies of water observed.

Children sign in and out procedures and logs were reviewed. Children's roster was reviewed, and a copy was provided to the LPA. LPA reviewed Ten (10) children's files during today's inspection. Each child's file reviewed contained the required forms.

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SUPERVISOR'S NAME: Gladys Kuizon	TELEPHONE: (510) 566-5850
LICENSING EVALUATOR NAME: Farida Raja	TELEPHONE: (916) 926-9269
LICENSING EVALUATOR SIGNATURE:	DATE: 09/26/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2023

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-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: CATALYST KIDS - HAYES	FACILITY NUMBER: 430709907
	VISIT DATE: 09/26/2023

NARRATIVE

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LPA reviewed three (3) staff files during today's inspection. All staff files reviewed contain the required transcripts/verification of experience. At least one staff member on site has a current CPR and First Aid certification on file. Director understands that there shall be at least one person, with valid CPR and First Aid certifications, on site at all times or present during off-site activities (field trips). All staff have the required Immunization's against Pertussis, Measles and Influenza/statement declining the influenza vaccine. LPA observed the required Mandated Reporter Training on file for all staff.

Director 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.

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 PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication. Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/. Director stated that facility does handle medications and currently has children in care who require Incidental Medical Services. Director provided a copy of the IMS Plan to LPA during today's inspection. Isolation of sick child was discussed, and Director explained that sick children will be isolated in the director's office and isolation equipment will be provided. A staff restroom which is off limits to other children is used if necessary. Child is always under visual supervision while in care of the facility.

Facility does not provide transportation to children, but Director understands that children cannot be left alone, unattended in parked vehicles.

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SUPERVISOR'S NAME: Gladys Kuizon	TELEPHONE: (510) 566-5850
LICENSING EVALUATOR NAME: Farida Raja	TELEPHONE: (916) 926-9269
LICENSING EVALUATOR SIGNATURE:	DATE: 09/26/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2023

LIC809 (FAS) - (06/04)

Page: 3 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: CATALYST KIDS - HAYES	FACILITY NUMBER: 430709907
	VISIT DATE: 09/26/2023

NARRATIVE

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Director 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&Rs) throughout California.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process

Exit interview conducted and report was reviewed with the Director, Diana Hosn.

As a result of today's inspection, there were no deficiencies cited.

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

SUPERVISOR'S NAME: Gladys Kuizon	TELEPHONE: (510) 566-5850
LICENSING EVALUATOR NAME: Farida Raja	TELEPHONE: (916) 926-9269
LICENSING EVALUATOR SIGNATURE:	DATE: 09/26/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2023

LIC809 (FAS) - (06/04)

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