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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434404888
Report Date: 03/07/2023
Date Signed: 03/07/2023 01:06:25 PM


Document Has Been Signed on 03/07/2023 01:06 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:CHALLENGER SCHOOL-STRAWBERRY PARKFACILITY NUMBER:
434404888
ADMINISTRATOR:CANDY HILLERFACILITY TYPE:
850
ADDRESS:730 CAMINA ESCUELATELEPHONE:
(408) 973-8787
CITY:SAN JOSESTATE: CAZIP CODE:
95129
CAPACITY:288CENSUS: 105DATE:
03/07/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Candy HillerTIME COMPLETED:
01:20 PM
NARRATIVE
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On 03/07/2023, Licensing Program Analyst (LPA) Pete Hernandez, met with Director, Candy Hiller, for a case management visit in regards to the lead testing results submitted by the facility and explained the reason for the visit to them. Present were 14 staff with children in care.

Facility submitted that there is an exceedance of about 17 (ppb) sample (M) from the preschool playground drinking fountain outside room A5 ,13 (ppb) sample (B) room A12 sink faucet, 11 (ppb) sample (K) north playground drinking fountain outside of room A4, 11 (ppb) sample (R) room A8 sink faucet, 7.7 (ppb) sample I room A3 sink faucet, 6.9 (ppb) sample (G) room A2 sink faucets, 5.8 (ppb) sample S room A9 sink faucets, and again 5.7 (ppb) sample (M) from the preschool playground drinking fountain outside room A5 dated 2/4/23. Director stated that all the above have been repaired and retested waiting for test result to be returned. They are expected to be returned mid-March 2023. The facility uses bottled water for the staff and children until the results clear retesting.

Director was advised that if permanent bottled water is to be used should the lead water tests are not favorable or repair costs are not feasible that a waiver need to me requested and approved by CCLD.

Type B deficiency was cited during today's visit. Director was informed that failure to correct the deficiencies by the specified Plan of Correction Due Date will result in assessment of civil penalties in the amount of $100 per day per violation until the correction is made. Exit interview conducted and report was reviewed with the Director, Candy Hiller, A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISOR'S NAME: Gladys KuizonTELEPHONE: (510) 566-5850
LICENSING EVALUATOR NAME: Pietro HernandezTELEPHONE: (408) 598-9250
LICENSING EVALUATOR SIGNATURE:
DATE: 03/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/07/2023
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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Document Has Been Signed on 03/07/2023 01:06 PM - It Cannot Be Edited

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: CHALLENGER SCHOOL-STRAWBERRY PARK
FACILITY NUMBER: 434404888

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/07/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/31/2023
Section Cited

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101700.3(b)(1)
Testing results with fractional ppb readings of 0.5 ppb or greater shall be rounded up to the nearest whole number, before comparing to the Action Level. A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance.
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By the POC date: Facility will provide proof of repairs and retest results by 3/31/2023. Identified fixtures are not to be used until cleared for use after retesting. Bottled water is provided to the children and staff until the Identified fixtures are repaired.
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Facility submitted that there is an exceedance of about 17 (ppb) sample (M) from the preschool playground drinking fountain outside room A5 ,13 (ppb) sample (B) room A12 sink faucet, 11 (ppb) sample (K) north playground drinking fountain outside of room A4, 11 (ppb) sample (R) room A8 sink faucet, 7.7 (ppb) sample I room A3 sink faucet, 6.9 (ppb) sample (G) room A2 sink faucets, 5.8 (ppb) sample S room A9 sink faucets, and again 5.7 (ppb) sample (M) from the preschool playground drinking fountain outside room A5 dated 2/4/23.
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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: Gladys KuizonTELEPHONE: (510) 566-5850
LICENSING EVALUATOR NAME: Pietro HernandezTELEPHONE: (408) 598-9250
LICENSING EVALUATOR SIGNATURE:
DATE: 03/07/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/07/2023
LIC809 (FAS) - (06/04)
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