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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434400031
Report Date: 08/27/2021
Date Signed: 08/27/2021 02:40:54 PM

Document Has Been Signed on 08/27/2021 02:40 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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:SANTA CLARA CHRISTIAN PRESCHOOLFACILITY NUMBER:
434400031
ADMINISTRATOR:JENDY NICEFACILITY TYPE:
850
ADDRESS:3421 MONROE STREETTELEPHONE:
(408) 246-5423
CITY:SANTA CLARASTATE: CAZIP CODE:
95051
CAPACITY: 75TOTAL ENROLLED CHILDREN: 75CENSUS: 26DATE:
08/27/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Principal Stuart NiceTIME COMPLETED:
11:30 AM
NARRATIVE
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(#1) Licensing Program Analyst (LPA) Anna Morales conducted an unannounced Annual Required inspection and was greeted by Principal/ Pastor Stuart Nice. Director Rachel Eaton was unavailable at the time of this visit. Facility's License, Notification of Parents’ Rights Poster, Child Car Seat Law, Personal Rights (LIC 613A), Emergency Disaster Plan, and Earthquake Preparedness Checklist were observed to be posted. The center's operating hours are Monday through Friday from Friday 7:00 AM to 6:00 PM. Age serve is 2 years old to entry to first grade. Last disaster drill was conducted in 8/17/2021

Currently, the Preschool Program is operating in Rooms 12,13,14 and 15. There is one playground that is shared between the following classrooms:
Room 12 (Brown Bears: Pre-K): 12, 2 teachers(qualified)
Room 13 (Panda Bears: 3.5 - 4 years): 7 children, 2 teachers (qualified)
Room 14 (Koala Bears: 3 - 4 years): 6 children, 1 teacher (qualified)
Room 15 (Polar Bears: 2 - 3.5 years): 11 children, 2 teachers (qualified)
Facility was observed to be in compliance with teacher to children ratio requirement during visit.
LPA toured the facility both indoor and outdoor. There were no bodies of water observed. Principal Nice stated that the facility do not have 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. Floors were clean.

Outdoor activity spaces are enclosed by fencing and are observed to be free of hazards. LPA observed play equipment were in good condition. Facility provides lunch and two snacks. LPA observed that food storage areas were clean and free of litter. (page 1)

Sandy Knight
Anna Morales
DATE: 08/27/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/27/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3
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: SANTA CLARA CHRISTIAN PRESCHOOL
FACILITY NUMBER: 434400031
VISIT DATE: 08/27/2021
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The children use the bathrooms that are located in one central area away from the classrooms. Fire extinguisher, smoke and carbon monoxide detectors were observed. The fire alarms and smoke detectors are hardwired.

This facility is providing Incidental Medical Services – IMS Plan. None of the children currently enrolled are using medication. Center has an isolation area if a child gets sick and is waiting for parent pick up.

LPA reviewed sign in and out record, and procedure. LPA reviewed a random selection of children files. Children records reviewed include Admission Agreement, Identification and Emergency Contact, Consent for Emergency Medical Treatment form, receipt of Parent Rights Notice, Personal Rights Notice, Medical Assessment, Immunization.

LPA reviewed a random selection of Staff records reviewed include Criminal Record and Child Abuse Index Clearance, Health Screening Report and TB test, Immunization (Measles, Pertussis, and Flu) record and required Training. LPA reminded the Principal that the online AB1207 Mandated Reported Training needs to be renewed every two years. All There was at least one person with current certification in Pediatric CPR and First Aid present at the facility.

LPA reminded the Principal for 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.

LPA also reviewed with Principal for the violations that would result in an immediate assessment of civil penalty in the amount of $500. Licensee is encouraged to visit the Department’s website at www.cdss.ca.gov to access resources for Providers, Regulations, Online option to pay Annual License fee, Adoption of new Laws, etc.
SUPERVISOR'S NAME: Sandy Knight
LICENSING EVALUATOR NAME: Anna Morales
LICENSING EVALUATOR SIGNATURE:

DATE: 08/27/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2021
LIC809 (FAS) - (06/04)
Page: 2 of 3
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: SANTA CLARA CHRISTIAN PRESCHOOL
FACILITY NUMBER: 434400031
VISIT DATE: 08/27/2021
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In the areas that were evaluated, there were no deficiencies cited.

LPA discussed the requirements of AB 633 with the Principal and understands the AB 633 fact sheet/copy of Acknowledgement of Receipt of Licensing Reports (LIC 9224). LPA discussed "zero tolerance" related regulations and advised that the assessment of an immediate $500 per day civil penalty for any violation of a "zero tolerance" related regulation. An ongoing civil penalty of $100 per day continues until the violation(s) is corrected.

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

NOTICE OF SITE VISIT WAS ISSUED. DIRECTOR WAS INFORMED TO POST THE NOTICE IN A VISIBLE LOCATION OF THE DAY CARE FOR A PERIOD OF 30 DAYS.
SUPERVISOR'S NAME: Sandy Knight
LICENSING EVALUATOR NAME: Anna Morales
LICENSING EVALUATOR SIGNATURE:

DATE: 08/27/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2021
LIC809 (FAS) - (06/04)
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