430710231-4-11-2023-07-CC-ALOZ-CQT23V-20230411170258

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 430710231
Report Date: 04/11/2023
Date Signed: 04/11/2023 05:03:10 PM

Document Has Been Signed on 04/11/2023 05:03 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 - CAMPBELL		FACILITY NUMBER:	430710231
ADMINISTRATOR:	LAURIE HAUFF		FACILITY TYPE:	830
ADDRESS:	1125 W. CAMPBELL AVE		TELEPHONE:	(408) 379-3184
CITY:	CAMPBELL	STATE: CA	ZIP CODE:	95008
CAPACITY:	80	CENSUS: 51	DATE:	04/11/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	02:01 PM
MET WITH:	Laurie Hauff		TIME COMPLETED:	05:10 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 infant program director, Laurie Hauff, for an unannounced Required- 1 Year Inspection. LPAs were granted access and toured both indoors and outdoors of the infant program. Upon arrival, there were 51 infants and 14 teachers present, which is compliant with the facility license capacity and ratio requirements. LPAs observed all required postings. The hours of operation are Monday – Friday, 7:00AM-6:00PM. The last fire/disaster drill was conducted on 3/29/23, which is compliant with the six-month requirement for facilities. LPAs observed a fully charged 2A10BC fire extinguisher and functioning fire/carbon monoxide detector. LPAs observed medication is properly stored out of reach of children with documentation. There are no weapons or firearms on the premises. 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 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 LPA discussed the safe sleep regulations with the director and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA reminded director that there can't be anything hanging from the crib, and to monitor infants while sleeping. LPA also informed the director of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

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 - CAMPBELL	FACILITY NUMBER: 430710231
	VISIT DATE: 04/11/2023

NARRATIVE

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Indoor areas were inspected by the LPAs today and observed to be clean, orderly, and safe for the infants. LPAs observed sufficient age-appropriate materials, toys, and play equipment in the facility. Drinking water is readily available for children via Brita water filter. Changing tables are clean and sanitary. Snacks are provided by the facility and are stored and served in a safe and healthful manner to the children. All infants enrolled provide their food from home.

The outdoor area of the facility was inspected and observed to be fenced in. LPAs observed play equipment was in good condition and age-appropriate. The playground needs additional resilient materials (tanbark) to absorb falls as area under the swings had visible ground underneath. Director stated that they are currently not using the swings. No outdoor bodies of water were observed during today’s inspection. Shaded rest area is provided by large trees and canopy.

Six (6) infants files and fourteen (14) staff files were reviewed during today’s inspection and all required documents were present. Laurie has current CPR/First-Aid that expires 7/31/23 and Mandated Reporter Training that expires on 10/18/2023.

Laurie understands that she shall be on the premises during the hours the center is in operation and that children at the center shall be visually supervised at all times. LPA's reminded that there shall be at least one person with valid CPR and First-Aid certifications on site at all times.

As a result of today’s inspection, no deficiencies were cited. Exit interview conducted and report was reviewed with the Director, Laurie Hauff
A NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 DAYS.

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.

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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