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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434408058
Report Date: 10/24/2019
Date Signed: 10/24/2019 04:11:06 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:CHALLENGER SCHOOL-SHAWNEEFACILITY NUMBER:
434408058
ADMINISTRATOR:NANCY NACIONALESFACILITY TYPE:
850
ADDRESS:500 SHAWNEE AVENUETELEPHONE:
(408) 365-9298
CITY:SAN JOSESTATE: CAZIP CODE:
95123
CAPACITY:154CENSUS: 78DATE:
10/24/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Bowden, Brad & Soriano, CristelTIME COMPLETED:
04:15 PM
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An unannounced Annual Random Inspection was conducted on this day, by Licensing Program Analyst (LPA) Almaraz, Araceli. Facility is currently licensed for a capacity of 154. Licensing staff met with Bowden, Bradley, principal of the elementary schools shared campus. The Director was not at the facility until later in the visit. The program currently operates 7 AM to 6 PM, Monday thru Friday. Licensing staff was taken on a guided tour of the facility of both indoors and outdoors. At the initial start of this visit, there is a total census of 78 children and a total census of ten teachers present. There is a rotational cleared, elementary qualified preschool teacher to relieve other teachers for breaks, for ratio purposes. Director Soriano presented proof of designation of facility responsibility, submitted to our office 07/21/2015, LPA Almaraz obtained proof of copy. Director Soriano has a directors permit and states has spoken previously to licensing staff regarding this and was told it would changed to the current Director.

PHYSICAL PLANT:
This is a preschool program which consists of classrooms: G1, G2, G3, B1, B2 and B3. All areas identified on the Facility Sketch were inspected. G1: The following was observed of this room during the inspection of the facility: Upon arrival room had zero teachers/staff, with zero preschool children. LPA Almaraz observed the following in the room: Access to two toilets and two sinks and drinking water located inside classroom .

G2: The following was observed of this room during the inspection of the facility: Upon arrival room had one teachers/staff, with 11 preschool children. LPA Almaraz observed the following in the room: Access to two toilets, two sinks and drinking water located inside classroom. Teacher and child ratios were observed and staff names recorded.

G3: The following was observed of this room during the inspection of the facility: Upon arrival room had two teachers/staff, with 17 preschool children. LPA Almaraz observed the following in the room: Access to two toilets, two sinks and drinking water located inside classroom. Teacher and child ratios were observed and staff names recorded. *****Page 1/4, Report Continued on Page 2*****

SUPERVISOR'S NAME: Mary SeguraTELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Araceli AlmarazTELEPHONE: (408) 334-8551
LICENSING EVALUATOR SIGNATURE:

DATE: 10/24/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/24/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 4
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: CHALLENGER SCHOOL-SHAWNEE
FACILITY NUMBER: 434408058
VISIT DATE: 10/24/2019
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B1: The following was observed of this room during the inspection of the facility: Upon arrival room had three teachers/staff, with 21 preschool children. LPA Almaraz observed the following in the room: Access to two toilets, two sinks and drinking water located inside classroom. Sleeping cots. Teacher and child ratios were observed and staff names recorded.

B2: The following was observed of this room during the inspection of the facility: Upon arrival room had two teachers/staff, with 13 preschool children. LPA Almaraz observed the following in the room: Access to two toilets, two sinks and drinking water located inside classroom. Sleeping cots. Teacher and child ratios were observed and staff names recorded.

B3: The following was observed of this room during the inspection of the facility: Upon arrival room had two teachers/staff, with 16 preschool children. LPA Almaraz observed the following in the room: Access to one toilet, one sink and drinking water located inside classroom. Sleeping cots. Teacher and child ratios were observed and staff names recorded. Bowden stated if a second toilet is needed child will be taken (by teacher with other children) to another toilet in close proximity either by the main office or to another classroom. This system ensures compliance of teacher/child ratio.

Based on observations made, LPA Almaraz concludes the following of all class rooms: All Furniture and equipment were inspected for age appropriateness and are in sufficient condition. Telephone service, heating, lighting and ventilation were evaluated. Children have their own cubicle to store their belongings. Per Bowden the isolation area is in the main office. General sanitation was observed. Disinfectants, cleaning solutions, medication and other hazardous items that pose a risk to children, were inaccessible to the children in care. Bowden states that poisons are locked in janitorial closet. All storage containers for solid waste, including moveable trash receptacles have tight-fitting covers that are kept on, and in standard condition. Waste is to be discarded immediately after each meal. First Aid supplies were observed in the classroom in cabinets. According to Bowden, medication is only administered to a child when accompanied with a doctor's note and is stored in the office. Carbon monoxide detectors and smoke detectors, in each classroom and are working presently in the facility. There is a Fire extinguisher size 3A40BC in each class room and all have been serviced on 07/27/2019. Classes B1, B2 and B3 are full day programs and have cots for napping. Napping equipment and bedding was inspected for good condition, appropriate storage and cleanliness. Storage for children's linens stored in each child's cubicle. Parents take linens home on Friday and return on Monday. LPA Almaraz and Bowden discussed getting a second accessible toilet for room B3. *****Page 2/4 , Report Continued on Page 3*****

SUPERVISOR'S NAME: Mary SeguraTELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Araceli AlmarazTELEPHONE: (408) 334-8551
LICENSING EVALUATOR SIGNATURE:

DATE: 10/24/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/24/2019
LIC809 (FAS) - (06/04)
Page: 2 of 4
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: CHALLENGER SCHOOL-SHAWNEE
FACILITY NUMBER: 434408058
VISIT DATE: 10/24/2019
NARRATIVE
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 LPA Almaraz also reviewed 11 staff records for completeness during inspection. Children's roster was reviewed and is current. Sign-In and Sign-Out sheets were reviewed, facility has s sticker system for parents. Children present were signed in. Disaster drill log was available, last drill was conducted on 10/23/2019. As part of admissions agreement parents are required to sign they have read, understood and agreed to all policies in handbook, polices include licensing inspection authority of Department of Social Services. .

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. 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

The following was discussed with Bowden: Rooms that are off-limits need to be made inaccessible. Smoking is prohibited. Bowden was advised that inaccessibility of hazards must be constantly reassessed depending on the children in care. The fire extinguisher type 3A40BC must be serviced annually or as often as necessary. Smoke and Carbon Monoxide detectors should be checked, batteries replaced as needed. Changes should be reported to the Department as soon as they occur such as construction, remodeling, telephone number changes and/or if you move from your location. Mandatory Forms for the children’s files and staff files, requirements for fire drills, earthquake drills and documentation were discussed. Role and responsibilities of being a Mandated Reporter were reviewed. Bowden was advised how to access forms and Regulations online at www.ccld.ca.gov. Bowden was made aware that it is Directors responsibility to know the regulations as well as anyone who assists in providing care. LPA Almaraz advised that all adults 18 years of age and older providing Care & Supervision and/or have continuous presence in the facility shall adhere to a criminal background clearance with the Department of Justice, FBI and Child Abuse Index Check. LPA Almaraz advised to log onto web site www.ccld.ca.gov to obtain forms and LIVE SCAN application. Records for all children and staff must be maintained for three (3) years after separation from the facility. Bowden was also advised of the requirement to report Unusual Incidents and/or injuries to the parent/guardian and to CCL within the time frame specified by the regulation. Bowden advised to visit www.shotsforschool.org for immunization information. These forms may also be downloaded from our website: www.ccld.ca.gov. There were no deficiencies cited during today's visit in accordance to the California Code of Regulations Title 22, Division 12, Chapter 1. NOTICE OF SITE VISIT ISSUED AND MUST BE POSTED FOR 30 CONSECUTIVE DAYS.*****Page 4/4, Final Page of Report*****

SUPERVISOR'S NAME: Mary SeguraTELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Araceli AlmarazTELEPHONE: (408) 334-8551
LICENSING EVALUATOR SIGNATURE:

DATE: 10/24/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/24/2019
LIC809 (FAS) - (06/04)
Page: 4 of 4
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: CHALLENGER SCHOOL-SHAWNEE
FACILITY NUMBER: 434408058
VISIT DATE: 10/24/2019
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There is Laundry service the facility uses if needed. All lavatories have appropriate water temperature, sufficient toilet paper, area safety and sanitation. LPA Almaraz observed soap dispenser and disposable towels in the lavatories. LPA Almaraz concludes, all rooms are currently in compliance with licensing standards.

Kitchen: All kitchen areas/food preparation areas and food storage areas are kept clean and are free of litter, rubbish and rodents and/or any other vermin. All storage containers for solid waste, including moveable bins shall have tight-fitting covers that are kept on, and in good repair. Snack/lunch menus are posted yearly and in advance where it is visible by the child's authorized representative in facility. Menus for the past five years are available upon request. Snacks/lunch items were reviewed for availability, and appropriateness to children in care. Children enrolled bring their own lunch. The facility provides AM and PM snacks.



Outdoor: Outdoor playground equipment is in a safe condition, free of sharp, loose or pointed parts. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. All areas around or under high climbing equipment, swings, slides, and similar equipment are cushioned with material that absorbs a fall. There is adequate shade in the play yard. Availability of outdoor drinking water was observed. Bowden states the sandboxes are covered each evening and removed each morning and additionally inspected by teachers. Bowden advised that indoor and outdoor supervision required at all times.

Personal Rights:


Care and supervision was evaluated to determine if the basic needs of children are met and appropriate. Personal Rights of children were observed by LPA. LPA Almaraz concludes based on observation facility is in currently in compliance with these requirements.

Facility Records:
All individuals present have obtained a criminal record clearance or criminal record exemption. There is at least one person trained in CPR and Pediatric First Aid present during this inspection. There were eight Children’s Records reviewed for completeness; Inspection of required forms was made. In review of children’s records, files contain information including, but not limited to the following: Name, address and telephone number of the child's authorized representative and of relatives or others who can assume responsibility for the child. *****Page 3/4, Report Continued on Page 4*****
SUPERVISOR'S NAME: Mary SeguraTELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Araceli AlmarazTELEPHONE: (408) 334-8551
LICENSING EVALUATOR SIGNATURE:

DATE: 10/24/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/24/2019
LIC809 (FAS) - (06/04)
Page: 3 of 4