434408868-1-29-2024-07-CC-FRAA-CZXNAU-20240129091806

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434408868
Report Date: 01/26/2024
Date Signed: 01/29/2024 09:18:36 AM

Document Has Been Signed on 01/29/2024 09:18 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME:	KR SMITH STATE PRESCHOOL		FACILITY NUMBER:	434408868
ADMINISTRATOR:	ANNA HEREDIA/DENISE NOEL		FACILITY TYPE:	850
ADDRESS:	2025 CLARICE DRIVE		TELEPHONE:	(408) 573-3349
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95122
CAPACITY:	42	CENSUS: 16	DATE:	01/26/2024
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	12:52 PM
MET WITH:	Elisa Hernandez		TIME COMPLETED:	04:00 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	On 01/26/2024 at 12:52pm, Licensing Program Analyst (LPA), Farida Raja, met with Director, Elisa Hernandez, for an unannounced Required-3 Year inspection. The facility is licensed to serve children ages 2.5 years to entry into kindergarten in rooms 38 and 39. The facility has two waivers on file for electronic sign in/ out and shared outside playground space with Katherine R. Smith Elementary School. LPA observed the required posted materials including menus and weekly lesson plans. Days and hours of operation are Monday through Friday, 7:45am- 4:45pm. Upon arrival, LPA did not observe any children. Director stated that only their morning program is operational at present and operates from 8am-11am. They have a afternoon program from 12:15pm-3:15pm which is not operational at this time. Facility is utilizing only Room 38 at this time. LPA observed that room 39 is not in use at present. LPA and Director toured the indoor and outdoor areas during today's inspection. The classrooms, children's restrooms and staff restrooms were inspected. Facility has central heating/cooling for comfort of children. Director states that there are no weapons or firearms on the premises. There is a working telephone at the facility (209-570-9576). Disinfectants, cleaning products and medicines are stored inaccessible to the children in care. All cabinets and drawers used for storage were observed to be child locked. Furniture and equipment were age appropriate and in good condition, free of sharp, loose, or pointed parts. Floors were clean and free from tripping hazards. Napping mats were appropriate but children do not nap here at present. LPA observed solid waste containers with tight-fitting lids in the rooms and restroom. Restrooms and sinks for children were observed to be safe, sanitary, and in working condition. Staff use the bathroom located in the staff lounge of the elementary school. Continued on Page 2

SUPERVISOR'S NAME: Gladys Kuizon	TELEPHONE: (510) 566-5850
LICENSING EVALUATOR NAME: Farida Raja	TELEPHONE: (916) 926-9269
LICENSING EVALUATOR SIGNATURE:	DATE: 01/26/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2024

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
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: KR SMITH STATE PRESCHOOL	FACILITY NUMBER: 434408868
	VISIT DATE: 01/26/2024

NARRATIVE

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LPA observed fire extinguishers, working smoke and carbon monoxide detectors. The facility has a built-in smoke detector/ fire system. Log shows that the last Fire Drill was conducted on 01/09/2024 which is compliant with the six-month requirement for facilities. LPA observed emergency and first aid bags near the exit to the outdoor area.

Drinking water is readily available for children in each room through a water dispenser and in the outdoor playground area through water coolers and disposable cups. Water lead testing was completed for the facility on 10/28/2022 and no Action Level Exceedances were reported.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP). LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP. LPA obtained a copy of the water lead test report along with the LIC 9275, LIC 9276 and facility sketch indicating water outlets tested. LPA observed covered drinking water fountains in the classrooms which were not tested for lead according to the water lead testing report. Director stated that children do not drink water from the water fountains and only use the water dispenser. LPA referred director to the Department website for lead: Lead Toxicity Prevention and Water Testing Information.

Facility provides snack to the children. Food storage and preparation areas were observed to be sanitary. LPA observed foods and beverages were stored safely to prevent contamination and spoilage. Food is provided through Kidango and is prepared and transported to the facility. LPA observed the monthly menus, refrigerator and freezer temperature logs and food restrictions/allergy list on the refrigerator.

Outdoor playground and play equipment was inspected and observed to be fenced in and free of hazards. LPA observed play equipment was in good condition, age-appropriate, and has sufficient resilient materials (interlocking rubber mats and grass) to absorb falls. Areas around and under high climbing equipment and slides were cushioned with rubber mats that absorbs falls. Shaded rest area is provided by trees. There were no bodies of water observed. Director stated the outdoor area is divided into zones and teachers are assigned a zone to help with supervision of children.

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SUPERVISOR'S NAME: Gladys Kuizon	TELEPHONE: (510) 566-5850
LICENSING EVALUATOR NAME: Farida Raja	TELEPHONE: (916) 926-9269
LICENSING EVALUATOR SIGNATURE:	DATE: 01/26/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2024

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
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: KR SMITH STATE PRESCHOOL	FACILITY NUMBER: 434408868
	VISIT DATE: 01/26/2024

NARRATIVE

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Children sign in and out procedures and logs were reviewed. Children's roster was reviewed, and a copy was provided to the LPA. LPA reviewed six (6) children's files during today's inspection. Each child's file reviewed contained the required forms.

LPA reviewed two (2) staff files. All staff files reviewed contain the required transcripts/verification of experience. All staff on site have current CPR and First Aid certification on file. Director 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). LPA also observed the required Mandated Reporter Training on file for all staff. Director, Elisa Hernandez submitted a director packet during today's inspection.

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.

Director stated that facility does handle medications but currently has no children in care who require Incidental Medical Services (IMS). Isolation of sick child was discussed, and Director explained that sick children will be isolated in the Room 39 which has a bathroom and isolation equipment will be provided. Child is always under visual supervision while in care of the facility. Director stated that any medications at the facility are stored in the classroom in high cabinets.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

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SUPERVISOR'S NAME: Gladys Kuizon	TELEPHONE: (510) 566-5850
LICENSING EVALUATOR NAME: Farida Raja	TELEPHONE: (916) 926-9269
LICENSING EVALUATOR SIGNATURE:	DATE: 01/26/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2024

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
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: KR SMITH STATE PRESCHOOL	FACILITY NUMBER: 434408868
	VISIT DATE: 01/26/2024

NARRATIVE

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Facility does not provide transportation to children, but Director understands that children cannot be left alone, unattended in parked vehicles. Director was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process

Exit interview conducted and report was reviewed with Director, Elisa Hernandez.

As a result of today's inspection, there were no deficiencies cited.

A NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 DAYS.

SUPERVISOR'S NAME: Gladys Kuizon	TELEPHONE: (510) 566-5850
LICENSING EVALUATOR NAME: Farida Raja	TELEPHONE: (916) 926-9269
LICENSING EVALUATOR SIGNATURE:	DATE: 01/26/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2024

LIC809 (FAS) - (06/04)

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