434400314-10-10-2019-07-CC-AALZ-BGTVE8-20191010162156

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434400314
Report Date: 10/10/2019
Date Signed: 10/10/2019 04:22:12 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:	BRIGHT HORIZONS-SAN JOSE		FACILITY NUMBER:	434400314
ADMINISTRATOR:	REBECCA ADAMS		FACILITY TYPE:	840
ADDRESS:	6120 LISKA LANE		TELEPHONE:	(408) 225-3276
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95119
CAPACITY:	53	CENSUS: 0	DATE:	10/10/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	03:30 PM
MET WITH:	Adams, Rebecca		TIME COMPLETED:	04:31 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

An unannounced Annual Random Inspection was conducted on this day by Licensing Program Analyst (LPA) Almaraz, Araceli. This Facility is currently licensed for a capacity of 53. Licensing staff met with Director Adams, Rebecca. The program currently operates 7:00 AM to 6:30 PM, Monday thru Friday. Licensing staff was taken on a guided tour of the facility of both indoors and outdoors. This is a school aged program consists of one classroom; The Pavilion Room. All areas identified on the Facility Sketch were inspected. There was a total census of 0 children in todays visit.

PHYSICAL PLANT: The following was observed of this room during the inspection of the facility: Upon arrival, The Pavilion Room had a total of 0 staff, and 0 school aged kids; Furniture and equipment were inspected for age appropriateness and are in sufficient condition. Children have their own area to store their belongings. General sanitation was observed. Availability of indoor drinking water was observed in classroom. Disinfectants, cleaning solutions, medication and other hazardous items that pose a risk to children, were inaccessible to the children in care. Director Adams states that all poisons in facility are locked. All storage containers for solid waste, including moveable trash receptacles have tight-fitting covers that are kept on, and in standard condition. First Aid supplies were observed in the classroom in backpacks. Age appropriate sinks and toilets were inspected for availability, good repair, water temperature, toilet paper, area safety and sanitation. There are two toilets, three sinks and a water dispenser for drinking water in this room. Director Adams states that there are currently there are three children enrolled in this program. LPA Almaraz concludes, this room is currently in compliance with licensing standards.

Kitchen There was two kitchen staff observed. All kitchen areas/food preparation areas and food storage areas are kept clean and are free of litter, rubbish, rodents, and/or any other vermin. All storage containers for solid waste, including moveable bins shall have tight-fitting covers that are kept on, and in good repair. Trash cans used to discard food have tight fitting lids or solid waste bags shall be discarded immediately after *****Report Continued on Page 2*****

SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Araceli Almaraz	TELEPHONE: (408) 334-8551
LICENSING EVALUATOR SIGNATURE:	DATE: 10/10/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2019

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 5

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: BRIGHT HORIZONS-SAN JOSE	FACILITY NUMBER: 434400314
	VISIT DATE: 10/10/2019

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
26
27
28
29
30
31
32

Mandatory Forms for the children’s files and staff files, requirements for fire drills, earthquake drills and documentation were discussed. Role and responsibilities of being a Mandated Reporter were reviewed. The Director was advised how to access forms and Regulations online at www.ccld.ca.gov. Director was made aware that it is his/her responsibility to know the regulations as well as anyone who assists in providing care. . LPA advised Director Adams that all adults 18 years of age and older providing Care & Supervision and/or have continuous presence in the facility shall adhere to a criminal background clearance with the Department of Justice, FBI and Child Abuse Index Check. Director Adams was reminded of the civil penalties for violation..

LPA Almaraz informed Director Adams to log onto web site www.ccld.ca.gov to obtain forms and LIVE SCAN application. Records for all children and staff must be maintained for three (3) years after separation from the facility. Director Adams was also advised of the requirement to report Unusual Incidents and/or injuries to the parent/guardian and to CCL within the time frame specified by the regulation. Director advised to visit www.shotsforschool.org for immunization information. Applicable citations and civil penalties were discussed.

There was one Type B deficiency cited during today's visit in accordance to the California Code of Regulations Title 22, Division 12, Chapter 1. Exit interview, copy of report was given. Appeal rights were issued and discussed.

NOTICE OF SITE VISIT ISSUES AND MUST BE POSTED FOR 30 CONSECUTIVE DAYS.

*****Final Page of Report, Continued from Page 4*****

SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Araceli Almaraz	TELEPHONE: (408) 334-8551
LICENSING EVALUATOR SIGNATURE:	DATE: 10/10/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2019

LIC809 (FAS) - (06/04)

Page: 5 of 5

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: BRIGHT HORIZONS-SAN JOSE	FACILITY NUMBER: 434400314
	VISIT DATE: 10/10/2019

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
26
27
28
29
30
31
32

FACILITY RECORDS
Children’s Records were reviewed for completeness; Inspection of required forms was made. LPA Almaraz issued the Children’s Record Review (LIC 857) to the facility during this inspection. In review of children’s records, files contain information including, but not limited to the following: Name, address and telephone number of the child's authorized representative and of relatives or others who can assume responsibility for the child if the authorized representative cannot be reached when necessary

Director Adams was advised that indoor and outdoor supervision required at all times. If outdoor area not adequately fenced, provider must be with children at all times when outdoors. These forms may also be downloaded from our website: www.ccld.ca.gov

Children's roster was reviewed and is current. Electronic Sign-in and out procedures were reviewed. Last fire drill conducted on 09/06/2019.

LPA also issued the Review of Staff records (LIC 859) to the licensee during this inspection. The LIC 857 and the LIC 859 documents the staff and children’s files that were reviewed during this inspection.

The following was discussed with Director Adams: Rooms that are off-limits need to be made inaccessible during operating hours. Smoking is prohibited. No infant walkers, no Johnny Jumpers, no excersaucers or any other item that falls into that category are allowed in facility. Director Adams was advised that inaccessibility of hazards must be constantly reassessed depending on the children in care. Sudden Infant Death Syndrome (SIDS) and Never-Shake-a-Baby were discussed. LPA Almaraz also provided Provider Information Network (PIN) 10-02-CCP regarding Safe Sleep Awareness Campaign during today’s inspection. The fire extinguishers must be serviced annually or as often as necessary. Smoke and Carbon Monoxide detectors should be checked and batteries replaced as needed. Changes should be reported to the Department as soon as they occur such as construction, remodeling, telephone number changes and/or if you move from your location.

*****Report Continued on Page 4*****

SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Araceli Almaraz	TELEPHONE: (408) 334-8551
LICENSING EVALUATOR SIGNATURE:	DATE: 10/10/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2019

LIC809 (FAS) - (06/04)

Page: 4 of 5

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: BRIGHT HORIZONS-SAN JOSE	FACILITY NUMBER: 434400314
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/10/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 11/12/2019 Section Cited	1 2 3 4 5 6 7	Bulldings and Grounds: The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children. This requirement was not met as evidenced by LPA Almaraz observed two air conditioning units that had direct access to the children in care with frayed metak material. This poses a potential risk to the health and safety of the children in care.
	1 2 3 4 5 6 7
	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: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Araceli Almaraz	TELEPHONE: (408) 334-8551
LICENSING EVALUATOR SIGNATURE:	DATE: 10/10/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2019

LIC809 (FAS) - (06/04)

Page: 2 of 5

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: BRIGHT HORIZONS-SAN JOSE	FACILITY NUMBER: 434400314
	VISIT DATE: 10/10/2019

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
26
27
28
29
30
31
32

each meal. Menus are posted one week in advance where it is visible by the child's authorized representative. Menus for the past 30 days are available upon request Snack/lunch menus were reviewed. Food and snacks were reviewed for availability, quantity and appropriateness to children in care. Food preparation areas were toured for safety, cleanliness and proper equipment. Breakfast, lunch and AM/PM snacks served daily. LPA Almaraz concludes, this area is currently in compliance with licensing standards.

Outdoor equipment was inspected for safety, cushioning material, good repair and appropriateness. LPA Almaraz observed there are two air conditioning units that have direct access to the children in care, some of their metal material is frayed. The play area has sand, director states Sandboxes are inspected daily and kept free of hazardous foreign materials. Required shade and access to drinking water were observed. LPA Almaraz advised that the children need to be within the direct care and supervision, including visual supervision of the teacher(s) at all times. Play area was inspected for inaccessibility to bodies of water; no bodies of water observed. LPA Almaraz concluded due to air-conditioning units this area is currently not in compliance with regulation 101238 (a) licensing standards.

There is a Fire extinguisher size 3A40BC in the class room and has been serviced on 11/12/2018. Care and supervision was evaluated to determine if the basic needs of children are met and appropriate.

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
All required postings were observed by LPA Almaraz.

Personal Rights of children were observed by LPA Almaraz. Carbon monoxide detectors and smoke detectors are working presently in the facility. There are two birds and a fish tank with appropriate cover in the lobby of the facility. Per Director Adams, the isolation area is in the office/reception area. According to Director Adams, medication is only administered to a child when accompanied with a doctor's note and is stored in the office. Telephone service, heating, lighting and ventilation were evaluated. LPA Almaraz concludes all point stated in this paragraph are currently in compliance with licensing standards.*****Report Continued on Page 3*****

SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Araceli Almaraz	TELEPHONE: (408) 334-8551
LICENSING EVALUATOR SIGNATURE:	DATE: 10/10/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2019

LIC809 (FAS) - (06/04)

Page: 3 of 5