434400309-8-11-2022-07-CC-JGSS-CH7U4Y-20220811151556

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434400309
Report Date: 08/11/2022
Date Signed: 08/11/2022 03:16:24 PM

Document Has Been Signed on 08/11/2022 03:16 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:	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:	08/11/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:20 AM
MET WITH:	Rosemari Ewell		TIME COMPLETED:	03:35 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), James Santos conducted an unannounced Required 1 Year inspection at the day care facility today and met with Rosemari Ewell, Director. There were no preschool children present during today's visit. Per Director, the preschool program is on summer break since 6/9/2022 and will resume on 8/17/2022. LPA toured the indoor and outdoor areas with Director. The preschool program is currently licensed in rooms PK1, PK2, and PK3. 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) and Activity Schedule are posted in the hallway. During today's visit, the preschool staff were preparing the classrooms and school materials for the upcoming new school year. The classroom areas, furniture and equipment were observed to be clean and in good condition. There are age appropriate toys available for children. Fire extinguishers, fire alarm, smoke and carbon monoxide detectors and emergency first aid were observed in the classrooms. The children's bathrooms were observed to be clean and sanitary. Chemicals and cleaning solutions are stored and inaccessible to children. Per Director, there are no weapons or firearms on the premises. Director stated that the children bring their own lunch and snacks from home and they stored in their lunch bags. *Continued on next page.*

SUPERVISOR'S NAME: Joel Segura	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: James G Santos	TELEPHONE: (408) 334-8556
LICENSING EVALUATOR SIGNATURE:	DATE: 08/11/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/11/2022

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: 08/11/2022

NARRATIVE

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The outside playground area is surrounded by appropriate fencing and was observed to be safe and free of hazards. The outdoor play equipment are in good condition and the surface area has sufficient resilient materials. There are no bodies of water observed.

LPA reviewed children's files. Children's records reviewed include Admission Agreement, Identification and Emergency Contact, Consent for Emergency Medical Treatment form, receipt of Parent Rights Notice, Personal Rights Notice, Physician's Report and Immunization Record.

LPA reviewed staff files. Staff records reviewed include Criminal Record Clearance, Immunization Record, CPR/First Aid, Mandated Reported Training, Qualifications and Education.

Per review of record, the center conducts emergency disaster drills monthly.

Director were reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

Care providers are 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.

No deficiencies cited. Exit interview conducted and report was reviewed with Director. A copy of the report was provided.

NOTICE OF SITE VISIT WAS ISSUED AND MUST REMAIN POSTED FOR 30 DAYS.

SUPERVISOR'S NAME: Joel Segura	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: James G Santos	TELEPHONE: (408) 334-8556
LICENSING EVALUATOR SIGNATURE:	DATE: 08/11/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/11/2022

LIC809 (FAS) - (06/04)

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