434404443-8-30-2022-07-CC-PHEZ-CHSS5E-20220830133414

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434404443
Report Date: 08/30/2022
Date Signed: 08/30/2022 01:34:31 PM

Document Has Been Signed on 08/30/2022 01:34 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
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME:	TEMPLE EMANU-EL PRESCHOOL		FACILITY NUMBER:	434404443
ADMINISTRATOR:	SMEAD, BARBARA		FACILITY TYPE:	850
ADDRESS:	1010 UNIVERSITY AVENUE		TELEPHONE:	(408) 293-8660
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95126
CAPACITY:	90	CENSUS: 65	DATE:	08/30/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:00 AM
MET WITH:	Barbara Smead		TIME COMPLETED:	12:45 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), Pete Hernandez conducted an unannounced Required 1 Year inspection to the Facility today. LPA met with Ms. Barbara Smead, Director, and explained the nature of today's visit to her. LPA toured the Facility both inside and outside during today's visit. LPA notes that the Facility is licensed in Rooms 11-15, Room 20 (upstairs) and Temple House on the premises of the Temple Emanu-el. LPA observed 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), Menu, and Activity Schedule. The facility has two waivers on file for the occasional use of the Sanctuary and Patio and the playground capacity. Room 11 /10 Children and 2 Teachers Room 12 /10 Children and 2 Teachers Room 13 /11 Children and 2 Teachers Room 14 /11 Children and 3 Teachers Room 15 / 9 Children and 2 Teachers Room 20 /14 Children and 2 Teachers Each child's file reviewed contains the required information. LPA reviewed five staff files and found that all have completed the required Mandated Reporter Training (AB1207) and the required immunization's against Pertussis, Measles, and Influenza (or opt out letter). The Director, and eleven staff have current CPR and First Aid certifications on file. Ms.Smead understands that there shall be at least one person, with valid CPR and First Aid certifications, on site at all times or present during off-site activities (field trips). LPA Reviewed the files of 10 children in care and 10 Staff files. All the required documentation was in the file. Ms. Smead understands the conditions, limitations, and capacity specifications of the Facility license. Ms. Smead understands that children shall be visually supervised at all times. REPORT CONTINUED ON THE FOLLOWING PAGE (REPORT DATED 08/30/2022):

SUPERVISOR'S NAME: Gladys Kuizon	TELEPHONE: (408) 314-5102
LICENSING EVALUATOR NAME: Pietro Hernandez	TELEPHONE: (408) 598-9250
LICENSING EVALUATOR SIGNATURE:	DATE: 08/30/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/30/2022

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
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: TEMPLE EMANU-EL PRESCHOOL	FACILITY NUMBER: 434404443
	VISIT DATE: 08/30/2022

NARRATIVE

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CONTINUATION OF PREVIOUS PAGE (REPORT DATED 08/30/2022):

A review of staff records today 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 reminded the Director of 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. Penalty amounts: $100.00 per person per day, minimum of $100.00 to a maximum of $500.00 per person for an initial violation and a minimum of $100.00 to a maximum of $3000.00 per person for any subsequent violations within a 12-month period.

LPA observed that all rooms are clean and safe for all children and staff. Ms. Smead states that the Facility has a third-party cleaning service that cleans the Facility Monday through Friday in the evenings. Drinking water is readily available for the children in each room and in the outdoor playground area via water fountains and personal water bottles. LPA observed solid waste containers with tight-fitting lids in the Facility. Staff and children's bathrooms are clean, sanitary, and operable. There is a separate staff bathroom not utilized by the children which an isolated child can use if needed. Ms. Smead states that there are no weapons or firearms on the premises.

The food preparation and storage areas are clean, free of litter & rubbish, and free of rodents and other vermin. Cleaning supplies are inaccessible to the children and stored in locked cabinets inaccessible to children. Any medications at the Facility are stored in a lock box in the Directors office.

LPA observed all furniture and equipment is in good condition and safe for the children. The playground area utilized by children is surrounded by appropriate fencing and the outdoor surfaces are safe for the children. LPA observed that the outdoor equipment is age appropriate and in good condition. The resilient materials (wood chips) in the outdoor playground area are sufficient. LPA did not observe any bodies of water.

LPA provided the Community Care Licensing’s website www.ccld.ca.gov, so the licensee can obtain updated licensing information, new regulations and access forms. LPA advised the licensee of their responsibility to stay current in regard to new regulations. LPA also provided the e-mail address for the advocates in order to be added to the quarterly newsletter mailing list childcareadvocatesprogram@dss.ca.gov.

SUPERVISOR'S NAME: Gladys Kuizon	TELEPHONE: (408) 314-5102
LICENSING EVALUATOR NAME: Pietro Hernandez	TELEPHONE: (408) 598-9250
LICENSING EVALUATOR SIGNATURE:	DATE: 08/30/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/30/2022

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
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: TEMPLE EMANU-EL PRESCHOOL	FACILITY NUMBER: 434404443
	VISIT DATE: 08/30/2022

NARRATIVE

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Director Smead has a current CPR and First Aid that expires 5/3/2022.

TYPE A language: Should there ever be issuance of Type A citations today, a copy of the Facility Evaluation Report LIC809 has to be posted on the wall and a copy to be given to all parents of currently and newly enrolled children for next 12 months. In addition, copy of LIC9224 Statement Acknowledging Receipt of Licensing Reports need to be signed and kept in child files.

A deficiency is NOT being cited based on the LPA observation, interviews conducted, and record review in accordance with the California Code of Regulations, Title 22. An exit interview was conducted and reviewed and developed with the Licensee. A copy of this report was discussed and left with the Licensee, Barbara Smead, whose signature on this form confirm receipt of these documents.

A NOTICE OF SITE VISIT WAS ISSUED, POSTED NEAR THE ENTRANCE TO THE FACILITY, AND MUST REMAIN POSTED FOR 30 DAYS.

SUPERVISOR'S NAME: Gladys Kuizon	TELEPHONE: (408) 314-5102
LICENSING EVALUATOR NAME: Pietro Hernandez	TELEPHONE: (408) 598-9250
LICENSING EVALUATOR SIGNATURE:	DATE: 08/30/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/30/2022

LIC809 (FAS) - (06/04)

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