430710433-11-22-2019-07-CC-SRED-BJ6VVU-20191122154655

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 430710433
Report Date: 11/22/2019
Date Signed: 11/22/2019 03:47:01 PM

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:	BOWERS STATE/DISTRICT PRESCHOOL		FACILITY NUMBER:	430710433
ADMINISTRATOR:	ROSIE FLORES		FACILITY TYPE:	850
ADDRESS:	2755 BARKLEY AVENUE		TELEPHONE:	(408) 423-1117
CITY:	SANTA CLARA	STATE: CA	ZIP CODE:	95051
CAPACITY:	87	CENSUS: 6	DATE:	11/22/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	12:40 PM
MET WITH:	Rosie Flores		TIME COMPLETED:	03:55 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 Analyst (LPA) Shannel Reed, conducted an unannounced annual/ random inspection to the Facility today. LPA met with Director, Rosie Flores, and explained the nature of today's inspection to her. The Facility is located on the campus of Bowers Elementary School. LPA notes that the State Preschool is licensed in Room 25, 26, & 27 (Title 5) and operates a half day program from 8:15 AM to 12:00 PM Monday through Friday during the calendar school year. The District Preschool is located in Room E (Title 22) and operates a full day program year round. The Facility also has an infant program (#434408763) on campus and that program is licensed in Portable F. LPA 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), Child Car Seat Law (PUB 269), Menus, and Activity Schedule. The Facility has four active waivers on file (commingling from 7 AM to 9 AM and 4 PM to 6 PM, shared playground usage with the kindergarten program at Bowers Elementary School, and shared bathroom usage with Bowers Elementary School). The Facility is in compliance with the conditions of all waivers. The program is operated by the Santa Clara Unified School District and all criminal background checks for staff are handled by the Department of Education and thus do not come under the jurisdiction of Community Care Licensing Division. LPA reviewed ten (10) children's during today's visit. Each child's file reviewed contains the Information and Emergency Information form (LIC 700) and immunization's. LPA reviewed six (6) staff files. All staff files reviewed contain the required transcripts/verification of experience, Mandated Reporter Training, and Immunization’s. The Director and at least one teacher has current CPR and First Aid certifications on file. The 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). LPA observed 1 teacher with six (6) preschool children in Portable E. The Director understands that children shall be visually supervised at all times. The Director states that she and the program director conduct spot checks weekly to ensure that the children are supervised at all times. REPORT CONTINUED ON THE FOLLOWING PAGE (REPORT DATED 11/22/2019):

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Shannel Reed	TELEPHONE: (408) 489-9484
LICENSING EVALUATOR SIGNATURE:	DATE: 11/22/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/22/2019

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: BOWERS STATE/DISTRICT PRESCHOOL	FACILITY NUMBER: 430710433
	VISIT DATE: 11/22/2019

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CONTINUATION OF PREVIOUS PAGE (REPORT DATED 11/22/2019):
LPA observed that all rooms are clean and safe for all children and staff. The Director states that the Santa Clara Unified School District provides the janitorial services Monday through Friday in the evenings. Drinking water is readily available for the children in each room and in the outdoor playground area via water pitchers/disposable cups. LPA observed solid waste containers with tight-fitting lids in each room. Staff and children's bathrooms are clean, sanitary, and operable. There is a separate staff bathroom not utilized by the children which an isolated child can use if needed. The Director states that there are no weapons or firearms on the premises.

The food preparation and storage areas are clean, free of litter & rubbish, and free of rodents and other vermin. All food and beverages that require refrigeration are stored in covered containers at 45 degrees F or less. Cleaning supplies are inaccessible to the children and stored in locked cabinets inaccessible to children. Any medications at the Facility are stored in a locked medicine box located in an upper cabinet.

LPA observed all furniture and equipment is in good condition and safe for the children. The playground area utilized by children is surrounded by appropriate fencing and the outdoor surfaces are safe for the children. LPA observed that the outdoor equipment is age appropriate and in good condition. LPA did not observe any bodies of water.

LPA provided the Community Care Licensing’s website www.ccld.ca.gov, so the licensee can obtain updated licensing information, new regulations and access forms. LPA advised the licensee of their responsibility to stay current in regard to new regulations. LPA also provided the e-mail address for the advocates in order to be added to the quarterly newsletter mailing list childcareadvocatesprogram@dss.ca.gov. LPA discussed Assembly Bill (AB) 2370 and gave Lead Safety information.

LPA obtained a Facility roster and conducted an exit review with the Director.

No Deficiency was cited during today’s inspection.

A NOTICE OF SITE VISIT WAS ISSUED, POSTED NEAR THE FACILITY ENTRANCE, AND MUST REMAIN POSTED FOR 30 DAYS.

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Shannel Reed	TELEPHONE: (408) 489-9484
LICENSING EVALUATOR SIGNATURE:	DATE: 11/22/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/22/2019

LIC809 (FAS) - (06/04)

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