434400309-10-21-2020-07-CC-MMOO-BULNQ2-20201021103912

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434400309
Report Date: 10/21/2020
Date Signed: 10/21/2020 10:39:59 AM

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:	ST. FRANCES CABRINI SCHOOL		FACILITY NUMBER:	434400309
ADMINISTRATOR:	EWELL, ROSEMARI		FACILITY TYPE:	850
ADDRESS:	15325 WOODARD ROAD		TELEPHONE:	(408) 377-6545
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95124
CAPACITY:	65	CENSUS: 0	DATE:	10/21/2020
TYPE OF VISIT:	Case Management - Other	ANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Jane Daigle		TIME COMPLETED:	10:35 AM

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 October 21, 2020 at 10:00 AM, Licensing Program Analyst (LPA), Marilou Monico, met Principal, Jane Daigle, for an announced tele-inspection via Zoom Meeting. LPA advised Jane that this Facility Evaluation Report (LIC 809) will be emailed to the facility. Facility’s reply to the email within 24 hours will serve as acknowledgement that the report was received. The purpose of the tele-inspection was to provide technical assistance in response to a waiver request for 12 school age children to attend the facility due to the spread of COVID-19 in California. The facility is currently licensed for children ages 2.9 years to entry into kindergarten in rooms: PK1, PK2, and PK3 . Principal Jane Daigle guided LPA on a tour of the facility via Zoom Meeting. The program plans to operate Monday - Friday, from 08:00 AM- 3:00 PM. The program plans to serve children in transitional kindergarten through 8th grade. The program plans on conducting daily health screening via SchoolSpeak app. Children will be drop off and pick up at the parking lot. If child/ren become ill during the course of the day, they will be placed in an isolation area located in the office. The program plans to use the Math Room (4-5). The facility plans to have 12 children with 1 staff in the room. Outdoor activities are planned to take place at the playground (Big Toys) located outside the main office building. Children will bring food for snacks and lunch from home. The program will ensure that children have access to drinking water at all times. 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: 10/21/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2020

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: ST. FRANCES CABRINI SCHOOL	FACILITY NUMBER: 434400309
	VISIT DATE: 10/21/2020

NARRATIVE

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Medication will not be administered at the facility.

The program plans to utilize the restroom comprised of 1 toilet and 1 sink located inside the Math Room which provide for individual privacy:

Hand washing and sanitizing stations are in place throughout the facility.

The facility sketch that was submitted to Licensing showed the Art Room as the child care waiver room. Jane stated they decided to use the Math Room closer to the office instead of the Art Room.

LPA advised Jane to submit an updated facility sketch.

Fire clearance was received for 12 children in the Math Room.

Community Care Licensing will provide on-going Technical Assistance (TA) to St. Frances Cabrini School.

Please feel free to contact the San Jose Child Care Regional Office at 408-324-2148.

Regional Manager: Carol Marcroft, telephone 408-324-2150
Licensing Program Manager: Sandy Knight, telephone 408-324-2151
Licensing Program Manager: Anthony Studebaker, telephone (408) 334-8553
Licensing Program Analyst: Marilou Monico, telephone 408-334-8549

SUPERVISOR'S NAME: Anthony Studebaker	TELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Marilou Monico	TELEPHONE: (408) 334-8549
LICENSING EVALUATOR SIGNATURE:	DATE: 10/21/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2020

LIC809 (FAS) - (06/04)

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