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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434406707
Report Date: 07/15/2019
Date Signed: 07/15/2019 02:30:36 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:ST. FRANCIS OF ASSISI PRESCHOOLFACILITY NUMBER:
434406707
ADMINISTRATOR:ROCHELLE LEGGETTFACILITY TYPE:
850
ADDRESS:5111 SAN FELIPE ROADTELEPHONE:
(408) 223-1562
CITY:SAN JOSESTATE: CAZIP CODE:
95135
CAPACITY:15CENSUS: 11DATE:
07/15/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Rochelle LeggettTIME COMPLETED:
02:30 PM
NARRATIVE
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On 07/15/19 Licensing Program Analyst (LPA) Monica Mathur conducted an unannounced Annual inspection of St. Francis of Assisi Preschool. LPA met with Director, Rochelle Leggett and explained the purpose of today's visit. Facility’s License, Parents’ Rights Poster, Personal Rights, Activity Schedules were observed to be posted. These days the facility is on a summer schedule till July 26 with operating days and hours Monday to Friday 8 AM to 2 PM.

The physical plant was inspected. LPA toured the building with the Director.
Indoor space: The preschool operates only in one classroom and the restroom used for children is outside the classroom in the Church side. There were 11 children playing in the outdoor playground during the time of inspection. There were 2 staff members present and directly supervising the children.

Disinfectants, cleaning solutions, and other items that are dangerous to the health and safety of children were stored in places inaccessible to them. Cabinets, drawers, and rooms used for storage were locked. Furniture and equipment were age appropriate and in good condition, free of sharp, loose, or pointed parts. Restroom for children was observed to be in safe, sanitary, and functioning condition. Floors were clean and free from tripping hazard. Facility does not provide snacks or meals, and children bring their own lunches. Trash cans for solid waste had tight-fitting covers on and were in good repair. Director stated that facility does not possess nor store any weapons on the premises. LPA observed a 3A40BC Fire extinguisher, Smoke and Carbon Monoxide Detectors, fire pull stations, and sprinkler system. Log shows that the last Fire Drill was conducted on 04/10/19. Facility does not provide transportation for children, but Director understands that children cannot be left alone, unattended in parked vehicles.
Continued on Page #2, Report dated 07/15/19
SUPERVISOR'S NAME: Sandy KnightTELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Monica MathurTELEPHONE: (408) 334-8312
LICENSING EVALUATOR SIGNATURE:

DATE: 07/15/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2019
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: ST. FRANCIS OF ASSISI PRESCHOOL
FACILITY NUMBER: 434406707
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/15/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/16/2019
Section Cited
CCR
101170(e)(1)
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CRIMINAL RECORD CLEARANCE 101170(e)(1): All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility obtain a California clearance or a criminal record exemption [...]. This requirement is not met as eivdenced by:
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By POC Due Date 07/16/19 Director agreed to send a written statement detailing how facility will stay complaint under this regulation moving forward.
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Per LPA's review and inspection, a staff Holly Tarver does not have fingerrpint clearances. She has been working with children for 5 days. Licensee failed to obtain California clearance for this individual. This poses an immediate risk to the children.
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Due to the issuance of a Type A Citation during today's inspection, a copy of this Licensing Report must be given to each existing parent by the end of today or next day child is in care, and to the parent of children enrolled over the next 12 months. In addition, a copy of the LIC 9224 Acknowledgement of Receipt of Licensing Reports must be signed by each parent and kept in each child's file. Civil penalty of $500 was assessed.

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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: Sandy KnightTELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Monica MathurTELEPHONE: (408) 334-8312
LICENSING EVALUATOR SIGNATURE:

DATE: 07/15/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2019
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: ST. FRANCIS OF ASSISI PRESCHOOL
FACILITY NUMBER: 434406707
VISIT DATE: 07/15/2019
NARRATIVE
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LPA reminded Director of the 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. For an initial violation, civil penalty amounts to $100.00 per person per day with a maximum of $500.00 per person. For a subsequent violation within a 12-month period, civil penalty amounts to $100.00 per person per day with a maximum of $3000.00 per person. LPA also reviewed with Director the violations that would result in an immediate assessment of civil penalty in the amount of $500. Director is encouraged to visit the Department’s website at www.cdss.ca.gov to access resources for Providers, Title 22 Regulations, Online option to pay Annual License fee, Adoption of new Laws, etc

Website for provider resources:
http://www.cdss.ca.gov/inforesources/Community-Care/Self-Assessment-Guides-and-Key-Indicator-Tools/Quarterly-Updates

childcareadvocatesprogram@dss.ca.gov

"Mandated Reporter" training for CA Child Care Providers that all staff are required to complete as of January 1, 2018. [Starting May 2019, both General Training followed by Child Care Providers Training is required to be taken]. The website for the online training is: http://www.mandatedreporterca.com/training/childcare.htm.

In the areas that were evaluated, regulatory violations were observed. A Type A citation was issued with Civil Penalties to the amount of $500 due to unauthorized staff working in facility for 5 days. Exit Interview was conducted, where this report, the citations, civil penalty, plan of corrections, and appeal rights were reviewed and discussed with Director. Report was signed by the Director confirming receipt of documents. Director was informed that failure to correct the deficiencies by the specified Plan of Correction Due Date may result in assessment of civil penalties in the amount of $100 per day per violation until the correction is made. Due to the issuance of a Type A Citation during today's inspection, a copy of this Licensing Report must be given to each existing parent by the end of today or next day child is in care, and to the parent of children enrolled over the next 12 months. In addition, a copy of the LIC 9224 Acknowledgement of Receipt of Licensing Reports must be signed by each parent and kept in each child's file. LPA gave the AB633 Fact Sheet to the Director. A NOTICE OF SITE VISIT WAS ISSUED, AND MUST BE POSTED ON OR ADJACENT TO THE INTERIOR SIDE OF THE MAIN DOOR INTO THE FACILITY FOR 30 CONSECUTIVE DAYS.
SUPERVISOR'S NAME: Sandy KnightTELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Monica MathurTELEPHONE: (408) 334-8312
LICENSING EVALUATOR SIGNATURE:

DATE: 07/15/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2019
LIC809 (FAS) - (06/04)
Page: 3 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: ST. FRANCIS OF ASSISI PRESCHOOL
FACILITY NUMBER: 434406707
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/15/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/16/2019
Section Cited
CCR
101216.2(e)
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TEACHER AIDE QUALIFICATIONS & DUTIES 101216.2 (e): An aide shall work only under the direct supervision of a teacher.
This requirement is not met as evidenced by:
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By POC Due Date 07/16/19 Director agreed to send to Licensing a written statement stating her understanding of this regulation and the plan Center will implement to ensure they stay in complaince moving forward.
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Per LPA's review of files, staff Daniel Vu has 3 ECE units and is currently enrolled in 6 more, which qualifies him to work as a Aide under the direct supervision of a fully qualified teacher. There was no fully qualified teacher present during LPA's inspection. This poses a potential risk to the health and safety of children.
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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: Sandy KnightTELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Monica MathurTELEPHONE: (408) 334-8312
LICENSING EVALUATOR SIGNATURE:

DATE: 07/15/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2019
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: ST. FRANCIS OF ASSISI PRESCHOOL
FACILITY NUMBER: 434406707
VISIT DATE: 07/15/2019
NARRATIVE
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Outdoor Space: Outdoor playground was inspected and observed to be safe. The play equipment was maintained in good condition and free of hazards. Areas around and under high climbing equipment and slides were cushioned with material that absorbs falls. There were no bodies of water observed. Drinking water is arranged to be readily available to children during indoor and outdoor activities.

File Review: Children sign in and out procedures and logs were reviewed. All children present were signed in by their authorized representative. A sampling of 11 Children's files and 3 Staff files was taken for review. All child files contained Admission Agreements and staff files contained educational units and other required licensing documents. There was at least one Teacher with current certification in Pediatric CPR and First Aid present at the facility during inspection. Children's Roster was reviewed, and a copy obtained. LPA's review of staff files showed that staff member, Holly Tarver did not have fingerprint clearances and was not associated to the facility. Per Director she has been working in the facility since 07/08/19. LPA also reviewed staff Daniel Vu's file and found that he is qualified as an Aide. Per regulation an Aide can only work under the direct supervision of a fully qualified teacher. There was no fully qualified teacher present with the children during the time of inspection. Deficiencies are being cited on 809-D pages of this report.

Director stated that facility does handle medications and currently does not have children in care who require Incidental Medical Services. LPA reviewed storage of medication and equipment / supplies. Isolation of sick child was discussed, and Director explained that a sick child is brought to the office area to be isolated from other children. An adult restroom is used if necessary. Child is always under visual supervision while being cared for.
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.

Beginning January 1, 2019 AB2370 requires licensed homes and centers to share information on the risks and effects of lead exposure with enrolling and re-enrolling families. LPA provided a copy of the “Lead Poisoning Facts Information Flyer” to the facility.
Continued on Page #3, report dated 07/15/19.
SUPERVISOR'S NAME: Sandy KnightTELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Monica MathurTELEPHONE: (408) 334-8312
LICENSING EVALUATOR SIGNATURE:

DATE: 07/15/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2019
LIC809 (FAS) - (06/04)
Page: 2 of 5