430710536-6-26-2019-07-CC-MMAR-BDJ2AF-20190626171329

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 430710536
Report Date: 06/26/2019
Date Signed: 06/26/2019 05:13:48 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:	YWCA DAVIDSON		FACILITY NUMBER:	430710536
ADMINISTRATOR:	RODRIGUEZ, JEANINE		FACILITY TYPE:	850
ADDRESS:	375 SOUTH THRID STREET		TELEPHONE:	(408) 295-4011
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95112
CAPACITY:	67	CENSUS: 29	DATE:	06/26/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	02:30 PM
MET WITH:	Jeanine Rodriguez/Lucille Gabriel		TIME COMPLETED:	03:30 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	On 06/26/19 Licensing Program Analyst (LPA) Monica Mathur conducted an unannounced Annual inspection of YWCA Davidson. This program has a preschool with toddler option. LPA met with Director, Jeanine Rodriguez and Program Director, Lucille Gabriel and explained the purpose of today's visit. Facility’s License, Parents’ Rights Poster, Personal Rights, Activity Schedules, and Menus were observed to be posted. Facility's operating days and hours are Monday to Friday 7 AM to 6 PM in the Toddler and Preschool rooms. There are active waivers on file for shared usage of infant playground and outdoor space. The physical plant was inspected. LPA toured the building with the Director. Indoor space: The Toddler classroom and restroom was inspected. Toddlers share a common restroom with the infant side, separated by a half wall and have child size toilets and sink. Restroom was observed to be in safe, sanitary, and functioning condition. Floors were clean and free from tripping hazard. There were two toddler staff members with seven toddlers at the time of inspection. It was their napping time and each toddler was sleeping on their mat, under the visual supervision of the staff. Facility was observed to be in compliance with teacher to children ratio requirement during LPAs' inspection. Preschool classroom: The Preschool classroom was inspected and LPA observed four staff members [two fully qualified and two aides] with 22 napping children. Preschool children have a separate restroom which was observed to be clean and sanitary. The kitchen, pantry, storage room, and office area were inspected. Disinfectants, cleaning solutions, and other items that are dangerous to the health and safety of children were stored in places inaccessible to them. Cabinets, drawers, and rooms used for storage were locked. Furniture and equipment were age appropriate and in good condition, free of sharp, loose, or pointed parts. Foods and beverages were stored safely. Food storage area were clean, free of litter, rubbish, and rodents/vermin. Trash cans for solid waste had tight-fitting covers on and were in good repair. Director stated that facility does not possess nor store any weapons on the premises. LPA observed a 3A40BC Fire extinguisher, Smoke and Carbon Monoxide Detectors, fire pull stations, and sprinkler system. Log shows that the last Fire Drill was conducted in May 2019. Facility does not provide transportation for children, but Director understands that children cannot be left alone, unattended in parked vehicles.

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Monica Mathur	TELEPHONE: (408) 334-8312
LICENSING EVALUATOR SIGNATURE:	DATE: 06/26/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2019

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: YWCA DAVIDSON	FACILITY NUMBER: 430710536
	VISIT DATE: 06/26/2019

NARRATIVE

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Outdoor Space: Outdoor playground was inspected and observed to be safe. The play equipment was maintained in good condition and free of hazards. Areas around and under high climbing equipment and slides were cushioned with rubber material that absorbs falls. There were no bodies of water observed. Staff takes a tray of personal water bottles outside during outdoor playtime, since they don't have a water fountain outside.

File Review: Children sign in and out procedures and logs were reviewed. A random sampling of toddler and preschool children's files and staff files was taken for review. All child files contained necessary licensing documents and staff files contained necessary transcripts and required licensing documents.There was at least one Teacher with current certification in Pediatric CPR and First Aid present at the facility during inspection.

Director stated that facility currently does not have children in care who require Incidental Medical Services. LPA reviewed storage of medication and equipment / supplies. Isolation of sick child was discussed, and Director explained that a sick child is brought to the office area to be isolated from other children. An adult restroom is used if necessary. Child is always under visual supervision while being cared for. 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.

Beginning January 1, 2019 AB2370 requires licensed homes and centers to share information on the risks and effects of lead exposure with enrolling and re-enrolling families. LPA provided a copy of the “Lead Poisoning Facts Information Flyer” to the facility.
LPA reminded 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 with a maximum of $500.00 per person. For a subsequent violation within a 12-month period, civil penalty amounts to $100.00 per person per day with a maximum of $3000.00 per person.

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Monica Mathur	TELEPHONE: (408) 334-8312
LICENSING EVALUATOR SIGNATURE:	DATE: 06/26/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2019

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: YWCA DAVIDSON	FACILITY NUMBER: 430710536
	VISIT DATE: 06/26/2019

NARRATIVE

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LPA also reviewed with Director the violations that would result in an immediate assessment of civil penalty in the amount of $500. Director is encouraged to visit the Department’s website at www.cdss.ca.gov to access resources for Providers, Title 22 Regulations, Online option to pay Annual License fee, Adoption of new Laws, etc.

In the areas that were evaluated, no regulatory violations were observed. Exit Interview was conducted, where this report was reviewed and discussed with Program Director. Report was signed by the Director confirming receipt of documents.

Website for provider resources:
http://www.cdss.ca.gov/inforesources/Community-Care/Self-Assessment-Guides-and-Key-Indicator-Tools/Quarterly-Updates

childcareadvocatesprogram@dss.ca.gov

"Mandated Reporter" training for CA Child Care Providers that all staff are required to complete as of January 1, 2018. [Starting May 2019, both General Training followed by Child Care Providers Training is required to be taken]. The website for the online training is: http://www.mandatedreporterca.com/training/childcare.htm.

A NOTICE OF SITE VISIT WAS ISSUED, AND MUST BE POSTED ON OR ADJACENT TO THE INTERIOR SIDE OF THE MAIN DOOR INTO THE FACILITY FOR 30 CONSECUTIVE DAYS.

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Monica Mathur	TELEPHONE: (408) 334-8312
LICENSING EVALUATOR SIGNATURE:	DATE: 06/26/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2019

LIC809 (FAS) - (06/04)

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