434404387-3-3-2020-07-CC-DMAC-BMD338-20200303165307

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434404387
Report Date: 03/03/2020
Date Signed: 03/03/2020 04:53:19 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:	SJB - CASSELL CHILD DEVELOPMENT CENTER		FACILITY NUMBER:	434404387
ADMINISTRATOR:	BRADBURY, AMBER		FACILITY TYPE:	840
ADDRESS:	2415 ARDEN WAY		TELEPHONE:	(408) 258-6518
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95122
CAPACITY:	54	CENSUS: 33	DATE:	03/03/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	02:45 PM
MET WITH:	Amber Bradbury		TIME COMPLETED:	05:10 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) Dung Mac met with Amber Bradbury, Site Director, at 2:46pm for an unannounced annual/random inspection. The school age program is Licensed in 2 rooms. The school age program hours are from 12:00pm to 6:00pm. LPA toured the Facility both inside and outside at 2:47pm. LPA did not observe any bodies of water. Amber states that there are no weapons or firearms on the premises. LPA observed outdoor activity space is physically separate from space for toddler and preschool. LPA observed there is a canopy and no climbing structures or slides. LPA observed cleaning supplies are inaccessible to the children. LPA observed all materials and surfaces accessible to children are toxic free. LPA observed furniture and equipment are in good condition, free of sharp or pointed parts. LPA observed children's bathrooms are clean and sanitary. LPA observed facility is clean and safe for children. LPA observed all required materials posted in both classrooms. LPA observed solid waste containers with tight-fitting lids in classrooms. Drinking water is available both indoor and outdoor. LPA observed that each classroom has one functioning carbon monoxide. Facility provides snacks only. Snack is prepared in central location and delivered to the facility. LPA observed food preparation and storage areas are kept clean. LPA reviewed staff and children files at 3:05pm. All staff and children files were complete. Staff files contain documentation of education background, training, and health screening. LPA observed one staff has current CPR and First Aid certifications on file. A review of staff records on 3/2/2020 indicates that all Facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. LPA observed there is a separate, complete, and current record maintained for each child. LPA observed child is signed in/out by the person responsible for the child. LPA observed the teacher/child ratio was in compliance during today's visit. LPA observed all children are under supervision at all times. LPA observed facility does not exceed the conditions, limitations, and capacity specified on the license. Continued on Page #2

SUPERVISOR'S NAME: Diana Stephenson	TELEPHONE: (408) 324-2158
LICENSING EVALUATOR NAME: Dung Mac	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR SIGNATURE:	DATE: 03/03/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2020

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: SJB - CASSELL CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 434404387
	VISIT DATE: 03/03/2020

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Continued from Page #1

Facility is currently not administering medications. Incidental Medical Services (IMS) was discussed. Incidental Medical Services (IMS) was discussed. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) and Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

LPA conducted an exit interview with the Amber. No deficiencies were cited during visit. A Notice of Site Visit was issued and must remain posted for 30 days.

SUPERVISOR'S NAME: Diana Stephenson	TELEPHONE: (408) 324-2158
LICENSING EVALUATOR NAME: Dung Mac	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR SIGNATURE:	DATE: 03/03/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2020

LIC809 (FAS) - (06/04)

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