430710492-10-6-2021-07-CC-MMOO-C7K2EC-20211006171945

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 430710492
Report Date: 10/06/2021
Date Signed: 10/06/2021 05:19:52 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:	ACTION DAY NURSERY		FACILITY NUMBER:	430710492
ADMINISTRATOR:	SAMANTHA SILVA		FACILITY TYPE:	830
ADDRESS:	3030 MOORPARK AVENUE		TELEPHONE:	(408) 249-0668
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95128
CAPACITY:	97	CENSUS: 50	DATE:	10/06/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	03:30 PM
MET WITH:	Brittany Strange & Madison Gates		TIME COMPLETED:	05:30 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	#2 Licensing Program Analyst (LPA) Marilou Monico conducted an unannounced Required - 1 Year inspection. LPA met with Site Director, Brittany Strange, and Administrative Staff, Madison Gates, and explained the purpose of today's inspection. Facility's License, Notification of Parents’ Rights Poster, Child Car Seat Law, Personal Rights (LIC 613A), Emergency Disaster Plan, Menus, Activity Schedule, and Earthquake Preparedness Checklist were observed to be posted. The center is open Monday through Friday from 07:30 AM to 5:30 PM. Age serve is birth to 2 years. The infant program is licensed in Rooms 1 thru 5, 6A, 6B, and 7. LPA toured the indoor and outdoor areas. LPA observed that the facility was operating in compliance with teacher to children ratio requirement. There were no bodies of water observed. Per Site Director, there were no weapons on the premises. Furniture and equipment were observed to be age appropriate and in good condition, free of sharp, loose, or pointed parts. Disinfectants, cleaning solutions, and other items that are dangerous to children were stored inaccessible to children. LPA observed diaper changing tables within arm's reach of a sink. Outdoor activity spaces are enclosed by fencing and are observed to be free of hazards. LPA observed play equipment were in good condition and areas around climbing structures have resilient material. Drinking water was readily available to children indoor and outdoor via individual bottles and sippy cups. Facility provides morning and afternoon snacks and are prepared in the snack room located in Building D. LPA observed that food storage areas were clean. Parents have the option to purchase hot lunch catered to the center from Action Day Primary Plus main kitchen located at 3500 Amber Drive, San Jose, CA 95117. The center has documentation that sleeping infants up to 12 months old were checked every 15 minutes. LPA advised Site Director that infants who are under 24 months old must be checked every 15 minutes and maintain documentation for each infant. LPA discussed and provided Site Director the new Safe Sleep Regulations. Diapers are being disposed appropriately. Each infant has personal items individually stored and labeled. LPA observed that the Infant Needs and Services Plan for four infants were not updated quarterly. Continuation on next page:

SUPERVISOR'S NAME: Anthony Studebaker	TELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Marilou Monico	TELEPHONE: (408) 334-8549
LICENSING EVALUATOR SIGNATURE:	DATE: 10/06/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/06/2021

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: ACTION DAY NURSERY	FACILITY NUMBER: 430710492
	VISIT DATE: 10/06/2021

NARRATIVE

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Foods and beverages were kept protected against contamination and spoilage. Trash cans for solid waste had tight-fitting covers on, and were in good repair. LPA observed working smoke detectors and functioning carbon monoxide detectors.

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 Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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.

LPA reviewed sign in and out procedures. LPA reminded Site Director that the online AB1207 Mandated Reported Training needs to be renewed every two years. Site Director has current certification in Pediatric CPR and First Aid.

A review of staff records during today's inspection indicates that all Facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. LPA reminded Site Director of the applicable civil penalties for those adults who have not received fingerprint clearances, are not associated to the license, and who come in contact with or provide care and supervision to the children. For an initial violation, civil penalty amounts to $100.00 per person per day up to $500.00 per person. For a subsequent violation within a 12-month period, civil penalty amounts to $100.00 per person per day up to $3000.00 per person.

Director's paperwork and copy of children's roster were obtained during the inspection.

Due to time constraints, LPA was not able to review the staff and children's files. LPA will return to the facility some other time.

As a result of this inspection, deficiency was cited on next page:

A copy of this report was provided to the facility at the conclusion of the inspection.

NOTICE OF SITE VISIT WAS ISSUED. SITE DIRECTOR WAS INFORMED TO POST THE NOTICE IN A VISIBLE LOCATION OF THE DAY CARE FOR A PERIOD OF 30 DAYS.

SUPERVISOR'S NAME: Anthony Studebaker	TELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Marilou Monico	TELEPHONE: (408) 334-8549
LICENSING EVALUATOR SIGNATURE:	DATE: 10/06/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/06/2021

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: ACTION DAY NURSERY	FACILITY NUMBER: 430710492
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/06/2021

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 10/13/2021 Section Cited	1 2 3 4 5 6 7	Modification to Infant Needs and Services Plan - The written infant needs and services plan shall be updated at least quarterly, or as often as necessary to assure its accuracy. (1) The director, the assistant director or a teacher shall update the plan with the assistance of the infant's authorized representative. (2) The authorized representative shall sign the plan to verify that he/she has participated in updating it.
	8 9 10 11 12 13 14	This requirement is not met as evidenced by: LPA observed that the Infant Needs and Services Plan for four infants were not updated quarterly. This poses a potential risk to the health and safety to children in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7
	1 2 3 4 5 6 7

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: Anthony Studebaker	TELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Marilou Monico	TELEPHONE: (408) 334-8549
LICENSING EVALUATOR SIGNATURE:	DATE: 10/06/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/06/2021

LIC809 (FAS) - (06/04)

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