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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434408868
Report Date: 02/26/2020
Date Signed: 02/26/2020 05:19:21 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:KR SMITH STATE PRESCHOOLFACILITY NUMBER:
434408868
ADMINISTRATOR:ANNA HEREDIA/DENISE NOELFACILITY TYPE:
850
ADDRESS:2025 CLARICE DRIVETELEPHONE:
(408) 573-3349
CITY:SAN JOSESTATE: CAZIP CODE:
95122
CAPACITY:42CENSUS: 8DATE:
02/26/2020
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
03:10 PM
MET WITH:Barbara CarmodyTIME COMPLETED:
05:25 PM
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Licensing Program Analysts (LPA) Dung Mac conducted an unannounced annual inspection to the facility today. LPA met with Barbara Carmody, Assistant Director Early Learning Services, and explained the nature of today's visit. The Facility is licensed in Rooms K5 & K6.

LPA toured the Facility both inside and outside for today's inspection. LPA observed the required materials posted in both classrooms. LPA reviewed children and staff files during today's inspection. All staff and children files were complete. Two staff have current CPR and First Aid certifications on file. Barbara understands that there shall be at least one person, with valid CPR and First Aid certifications, on site at all times or present during off-site activities (field trips).

The program is operated by the Santa Clara County Office of Education and all criminal background checks for staff are handled by the Department of Education and thus do not come under the jurisdiction of Community Care Licensing Division.

LPA observed the facility is clean and safe for children. LPA observed that the teacher/child ratio was in compliance during today's visit. LPA observed 8 preschool children with one teacher and one teacher aide in K6. All children in K5 went home at 3:15pm. LPA observed solid waste containers with tight-fitting lids in the facility. Children's bathrooms are clean and sanitary. Barbara states that there are no weapons or firearms on the premises. LPA observed that both classrooms have one functioning carbon monoxide. Drinking water is readily available for the children in each room via faucet.

Snack is brought by Revolution Foods on Monday-Friday. LPA observed cleaning supplies are inaccessible to the children. No medication is being administered by the Facility at this time. LPA observed all furniture and equipment is in good condition and safe for the children. The playground area is shared with Elementary School and is surrounded by appropriate fencing and the outdoor surfaces are safe for the children. LPA observed that the outdoor equipment is age appropriate and in good condition. LPA did not observe any bodies of water.

LPA conducted an exit interview with the Barbara. No deficiencies were cited during visit. A Notice of Site Visit was issued and must remain posted for 30 days.
SUPERVISOR'S NAME: Diana StephensonTELEPHONE: (408) 324-2158
LICENSING EVALUATOR NAME: Dung MacTELEPHONE: (408) 334-8550
LICENSING EVALUATOR SIGNATURE:

DATE: 02/26/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/26/2020
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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