430710222-4-11-2023-07-CC-ALOZ-CQT268-20230411170643

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 430710222
Report Date: 04/11/2023
Date Signed: 04/11/2023 05:07:01 PM

Document Has Been Signed on 04/11/2023 05:07 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:	PRIMARY PLUS, INC.		FACILITY NUMBER:	430710222
ADMINISTRATOR:	JENNA FENNELL		FACILITY TYPE:	850
ADDRESS:	1125 WEST CAMPBELL AVE		TELEPHONE:	(408) 379-3184
CITY:	CAMPBELL	STATE: CA	ZIP CODE:	95008
CAPACITY:	320	CENSUS:	DATE:	04/11/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:50 AM
MET WITH:	Laurie Hauff		TIME COMPLETED:	02:00 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) Ashley Lopez and Samantha Yip met with Laurie Hauff, the infant program director, for an unannounced Required - 1 Year inspection. LPAs toured the indoor and outdoor areas of the Facility with Laurie during today's inspection. LPAs observed the required posted materials, including the Facility License, Emergency Disaster Plan (LIC 610), Earthquake Preparedness Checklist (LIC 9148), Parents' Rights Poster (PUB 393), Personal Rights (LIC 613A), and Child Car Seat Law (PUB 269). Days and hours of operation are Monday through Friday 7:00AM-6:00PM. LPAs reviewed 10 of children’s and 11 staff files during today's inspection. Children’s Records were reviewed for completeness and inspection of required forms was made. In review of children’s records, files contain information including: Name, address and telephone number of the child's authorized representative and of relatives or others who can assume responsibility for the child if the authorized representative cannot be reached when necessary. All staff files reviewed contain the required transcripts/verification of experience/immunization records, and Health Screening Report. All staff have current certificates of completion of the Mandated Reporter Training for Child Care Workers on file. Some of the staff have current CPR and First Aid certifications. Director understands that there shall be at least one person, with valid CPR and First Aid certifications, on site at all times. Facility will send all required documents for new director Alyssa Contreras by 4/21/23.

SUPERVISOR'S NAME: Joel Segura	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Ashley Lopez	TELEPHONE: (916) 798-3658
LICENSING EVALUATOR SIGNATURE:	DATE: 04/11/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2023

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: PRIMARY PLUS, INC.	FACILITY NUMBER: 430710222
	VISIT DATE: 04/11/2023

NARRATIVE

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LPAs observed that the teacher/child ratio was in compliance during today's inspection. LPAs observed 62 children present and 18 staff members during today's inspection. Director understands that children shall be visually supervised at all times including when they are in the restroom. Any child who exhibit symptoms of illness including, but not limited to, fever or vomiting, are not accepted in care. Any child who becomes ill during the day, shall be isolated in the school office.

LPAs observed that the Facility is clean, safe, sanitary, and in good repair for children, staff, and visitors. Director states that the Facility has a third-party cleaning service. Director understands that the facility must be kept free of flies and other insects & rodents. LPAs observed that all furniture and equipment is in good condition and safe for the children. Drinking water is readily available for the children (or provided by parents) and in the outdoor playground area via water bottles/pitchers/disposable cups. Children's bathrooms are clean, sanitary, and operable. There is a separate staff bathroom not utilized by the children. Director states that there are no weapons or firearms on the premises. The Facility has functioning smoke/carbon monoxide detectors in each Classroom. LPA discussed with Infant Director about the temperature in the room needs to be a minimum of 68 degrees.

All food and beverages that require refrigeration are stored in covered containers at 45 degrees F or less. The Facility provides snack and hot lunch can be purchased. Parents provide lunches for the children. The Facility has trash cans with tight fitting lids for solid waste in each Room. Cleaning supplies are inaccessible to the children and stored inaccessible to children.

SUPERVISOR'S NAME: Joel Segura	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Ashley Lopez	TELEPHONE: (916) 798-3658
LICENSING EVALUATOR SIGNATURE:	DATE: 04/11/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2023

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: PRIMARY PLUS, INC.	FACILITY NUMBER: 430710222
	VISIT DATE: 04/11/2023

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This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. Any medications at the Facility are individually stored in school office. LPAs discussed with about obtaining written permission from the child's authorized representative for any medication. 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)/ (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

The playground area utilized by children is surrounded by appropriate fencing and the outdoor surfaces are safe for the children. LPAs observed that the outdoor equipment is age appropriate and in good condition. Shade is provided by trees and building overhang in the playground. LPAs discussed adding more resilient materials in the outdoor playground area with the director. LPAs did not observe any bodies of water.

The 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 $500.00 maximum per day/per person will be assessed if this regulation is violated.

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/inspection-process.

As a result of this inspection, a Type B citation were issued. Exit interview was conducted and the report was reviewed with the infant program director Laurie Hauff. A notice of site visit was given and must remain posted for 30 days.

SUPERVISOR'S NAME: Joel Segura	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Ashley Lopez	TELEPHONE: (916) 798-3658
LICENSING EVALUATOR SIGNATURE:	DATE: 04/11/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 04/11/2023 05:07 PM - 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-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: PRIMARY PLUS, INC.	FACILITY NUMBER: 430710222
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 04/11/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101229.1(b)

Sign In and Sign Out

(b) The person who brings the child to, and removes the child from, the center shall sign the child in/out. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in five out of 64 persons which poses a potential health, safety or personal rights risk to persons in care. LPAs observed there were 64 children. Five children were not signed in.
	POC Due Date: 04/18/2023
	Plan of Correction
1 2 3 4	Submitting plan of how they will ensure children are signed in.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Joel Segura	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Ashley Lopez	TELEPHONE: (916) 798-3658
LICENSING EVALUATOR SIGNATURE:	DATE: 04/11/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2023

LIC809 (FAS) - (06/04)

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