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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434404912
Report Date: 09/02/2022
Date Signed: 09/02/2022 04:56:46 PM

Document Has Been Signed on 09/02/2022 04:56 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:ROSEMARY PRESCHOOLFACILITY NUMBER:
434404912
ADMINISTRATOR:HEATHER ELSTONFACILITY TYPE:
850
ADDRESS:401 WEST HAMILTON AVENUETELEPHONE:
(408) 341-7127
CITY:CAMPBELLSTATE: CAZIP CODE:
95008
CAPACITY: 180TOTAL ENROLLED CHILDREN: 77CENSUS: 35DATE:
09/02/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:40 PM
MET WITH:Mylene Ignacio, Assistant DirectorTIME COMPLETED:
05:05 PM
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Licensing Program Analyst (LPA), James Santos conducted an unannounced a case management visit today and met with Assistant Director,Mylene Ignacio. The purpose of the visit was in regards to the Unusual Incident Report sent to the Department by the daycare center facility involving a staff (S1). Per report, another staff witnessed S1's interactions with two children on two separate occasions which she had concerns. Staff notified the preschool supervisor on 8/23.

Per report, on 8/1 during nap time at around 12pm, staff witnessed S1 pulled a child by the leg to lay him down and the child began crying. Per LPA's interview with staff, the children were transitioning from the bathroom and were getting ready for nap. On 8/22 at around 10am during circle time, another child was moving around the floor. Per report, S1 tried to redirect the child but the child did not comply. S1 picked up the child and placed him on a couch by the social emotional area. The child began to cry. The child stayed in the social emotional area for about 5 minutes, played with a toy and was asked to join back into the circle. Another staff (lead teacher) witnessed the incident and spoke to S1 about appropriate redirecting behaviors. Per interview with the lead teacher, S1 acknowledged the mistake. On the same day, 8/22 at around 12pm, the same child was getting ready to take a nap but was making noises. S1 tried to rub the child's back and verbally redirected the child couple of times but the child did not respond. S1 picked up the child and put him down on the mat but ended up hitting his head onto the floor. The child started to cry. S1 sat with the child, patted him on the back and child eventually fell asleep.


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Joel Segura
James G Santos
DATE: 09/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/02/2022
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: ROSEMARY PRESCHOOL
FACILITY NUMBER: 434404912
VISIT DATE: 09/02/2022
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Per incident report, preschool management conducted their own investigations and reported to their Human Resources Representative. Management also reported and spoke with both children's parents. As a result of preschool management's investigations and review of their program's zero tolerance policy for using physical guidance, S1's employment was terminated.

Due to additional information needed, this case management needs further investigation.


Exit interview conducted and report was reviewed with Assistant Director, Mylene Ignacio. A copy of this report was provided to Assistant Director.


A notice of site visit was given and must remain posted for 30 days.
SUPERVISOR'S NAME: Joel Segura
LICENSING EVALUATOR NAME: James G Santos
LICENSING EVALUATOR SIGNATURE:

DATE: 09/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/02/2022
LIC809 (FAS) - (06/04)
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