434408853-10-9-2019-07-CC-MMOO-BGSUZW-20191009160213

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434408853
Report Date: 10/09/2019
Date Signed: 10/09/2019 04:02:22 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:	NEIGHBORHOOD CHRISTIAN PRESCHOOL		FACILITY NUMBER:	434408853
ADMINISTRATOR:	MONETTE DAWSON		FACILITY TYPE:	830
ADDRESS:	1670 MOORPARK AVENUE		TELEPHONE:	(408) 286-0901
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95128
CAPACITY:	28	CENSUS:	DATE:	10/09/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	01:45 PM
MET WITH:	Julie Kennedy		TIME COMPLETED:	04:10 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 Analysts (LPAs), Marilou Monico and Pete Hernandez, met with Executive Director, Julie Kennedy, for an unannounced annual random inspection. The infant program is licensed in Infant Center Room and A3. LPAs observed all required posted materials: License, Parents' Rights, Emergency Disaster Plan, Earthquake Preparedness Checklist, Child Passenger Safety Law, and activity schedule. The infant program's days and hours of operation are Monday to Friday from 6:30 AM to 6:00 PM. There is an active waiver to allow the Toddler Option Program to share the space used by the Infant Program between 6:30 AM to 7:30 AM and 5:00 PM to 6:00 PM, in the Infant Room or in Room A-3. LPAs inspected the building both indoor and outdoor. LPAs observed that the facility was operating in compliance with teacher to children ratio requirement. Children were engaged in activities under the supervision of the teachers. Staff bathrooms are sanitary and operable. LPAs observed trash cans with tight fitting covers in the classrooms. There is functioning carbon monoxide detectors and smoke detectors at the facility. LPAs did not observe any bodies of water. LPAs reviewed ten random children's files and two staff files. At least one staff member present during the inspection has current CPR/First Aid certifications. Per Executive Director, there are no weapons on the premises. LPAs obtained copies of children's roster. LPAs observed four children in the infant program are missing updated Infant Needs and Services Plan. Outdoor activity area is enclosed by fencing. Shade is provided by trees and canopies. The areas around climbing equipment have resilient material to absorb falls. Drinking water was readily available to children indoor and outdoor via sippy cups and bottles. Parents provide meals and snacks for their children. (REPORT CONTINUED ON THE FOLLOWING PAGE (PAGE #2 - REPORT DATED 10/09/19):

SUPERVISOR'S NAME: Anthony Studebaker	TELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Marilou Monico	TELEPHONE: (408) 334-8549
LICENSING EVALUATOR SIGNATURE:	DATE: 10/09/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2019

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 3

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: NEIGHBORHOOD CHRISTIAN PRESCHOOL	FACILITY NUMBER: 434408853
	VISIT DATE: 10/09/2019

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
26
27
28
29
30
31
32

CONTINUATION OF PREVIOUS PAGE (PAGE #1 - REPORT DATED 10/09/19):

Staff present during the inspection have cleared criminal record and child abuse index clearances or exemptions. LPA also reminded Executive 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. Penalty amounts: 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 violation within a 12 month period.

LPAs discussed Senate Bill 792, AB 633, Assembly Bill (AB) 1207 (Mandated Child Abuse Reporter Training) which is required training that began on January 1, 2018 and requires renewal every two years with Executive Director. Licensing forms, Title 22 regulations, can be obtained through the internet at ww.ccld.ca.gov. Mandated Reporter Training can be accessed at www.mandatedreporterca.com.

LPAs observed that all staff completed the Mandated Reporter Training provided by the County of Santa Clara Social Services Agency. Executive Director agrees to have all staff complete the Mandated Reporter Training online to meet AB 1207 requirements and submit proof of completion by November 9, 2019.

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. LPAs provided a copy of the “Lead Poisoning Facts Information Flyer” to the facility.

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.

As a result of this inspection, deficiency was cited on the following page:

A NOTICE OF SITE VISIT WAS ISSUED AND MUST BE POSTED FOR 30 CONSECUTIVE DAYS.

SUPERVISOR'S NAME: Anthony Studebaker	TELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Marilou Monico	TELEPHONE: (408) 334-8549
LICENSING EVALUATOR SIGNATURE:	DATE: 10/09/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2019

LIC809 (FAS) - (06/04)

Page: 2 of 3

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: NEIGHBORHOOD CHRISTIAN PRESCHOOL	FACILITY NUMBER: 434408853
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/09/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 10/16/2019 Section Cited	1 2 3 4 5 6 7	Modifications to Infant Needs and Services Plan - The written infant needs and services plan shall be updated at least quarterly, or as often as necessary to assure its accuracy. This requirement is not met as evidenced by: LPAs observed Child #1 thru #4 are missing updated Infant Needs and Services Plan. This poses a potential risk to the health and safety to children in care.
	1 2 3 4 5 6 7
	1 2 3 4 5 6 7
	1 2 3 4 5 6 7

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: Anthony Studebaker	TELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Marilou Monico	TELEPHONE: (408) 334-8549
LICENSING EVALUATOR SIGNATURE:	DATE: 10/09/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2019

LIC809 (FAS) - (06/04)

Page: 3 of 3