434408883-10-27-2021-07-CC-PHEZ-C87TNX-20211027145327

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434408883
Report Date: 10/27/2021
Date Signed: 10/27/2021 02:53:41 PM

Document Has Been Signed on 10/27/2021 02:53 PM - It Cannot Be Edited

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:	HEARTS AND HANDS CHRISTIAN CHILDCARE AND PRESCHOOL		FACILITY NUMBER:	434408883
ADMINISTRATOR:	BOBBIE RODRIGUEZ		FACILITY TYPE:	850
ADDRESS:	1353 WEST HEDDING STREET		TELEPHONE:	(408) 244-0132
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95126
CAPACITY: 63	TOTAL ENROLLED CHILDREN: 63	CENSUS: 19	DATE:	10/27/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Bobbie Rodriguez		TIME COMPLETED:	03:00 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	Licensing Program Analysts (LPA) Pete Hernandez conducted an unannounced annual random inspection. LPA met with Ms. Bobbie Rodriguez, Director, and explained the reason of the inspection. Present during the inspection were 18 children and 6 staff. The staff child ratio was observed to be in compliance during today's inspection. Normal Business hours are Monday through Friday 6:30 am to 6:30pm. LPAs reviewed sign in/sign out sheet, which contains full legal signature. There were two Children whose parents did not sign the child in. License, Emergency Disaster Plan and Notification of Parents were observed to the posted. LPA toured in the inside and outside of the facility with Director. The facility was observed to clean and sanitary for children in care. Disinfectants, cleaning supplies, and other items that are dangerous to children were observed to stored inaccessible to children in care. LPAs observed there is sufficient amount of age-appropriate toys. Furniture and equipment, such as napping cots, chairs, and tables, were a good condition and age appropriate. Restroom for children's use were observed to be clean and sanitary. Storage containers for waste have tight fitted lids. LPA observed a fully charged fire extinguisher and smoke detector with fire pull stations. The last fire/earthquake drill was conducted on 09/29/2021. Director stated that there are no weapons stored on the premises. The outside area is fenced. Play structure was observed to in good condition. Areas around play structure have resilient material to absorb falls. Shaded rest area is provide through canopy and pergola. No bodies of water were observed during today's inspection. -----------------continues on 809c dated 10/27/2021 page 2----------------------------------------

SUPERVISORS NAME: Sandy Knight
LICENSING EVALUATOR NAME: Pietro Hernandez
LICENSING EVALUATOR SIGNATURE:	DATE: 10/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/27/2021

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: HEARTS AND HANDS CHRISTIAN CHILDCARE AND PRESCHOOL	FACILITY NUMBER: 434408883
	VISIT DATE: 10/27/2021

NARRATIVE

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---------------------continuation of 809 dated 10/27/2021 page 1-----------------------------------
Facility only provides snacks to the children. Menu was observed to be posted. Kitchen used to prepare snacks were observed to be clean and sanitary. All meals are prepared and brought from home. Drinking water is provided through individual water bottles, water pitchers, and cups.

10 children's files were reviewed during today's inspection. The records reviewed include but not limited to admission agreement and physician's report.

6 staff files were reviewed during today's inspection. The records reviewed include but not limited education credit and Mandated Reporter Training. LPA reminded Director that Mandated Reporter Training requires renewal every 2 years. All of the staff have current mandated reporter certificates. The Director has a current CPR/1st aid card that expires on 2/2022. Director understands that at least on staff needs to have a current CPR / 1st aid certificates during business hours.

All staff present have cleared criminal record clearance and child abuse index clearance. LPA also 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. Penalty amounts: $100.00 per person per day, 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.

Director stated that she currently does not have any children in care who requires Incidental Medical Services (IMS) services. IMS policy was discussed. 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.

Director is encouraged to visit the Department’s website at www.cdss.ca.gov to access resources for Providers, Title 22 Regulations, Online Licensing Forms, Adoption of new Laws, etc.

SUPERVISORS NAME: Sandy Knight
LICENSING EVALUATOR NAME: Pietro Hernandez
LICENSING EVALUATOR SIGNATURE:	DATE: 10/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/27/2021

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: HEARTS AND HANDS CHRISTIAN CHILDCARE AND PRESCHOOL	FACILITY NUMBER: 434408883
	VISIT DATE: 10/27/2021

NARRATIVE

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A copy of the children's roster and sign in and sign out sheets were provided to the LPA.

TYPE A language: Should there ever be issuance of Type A citations today, a copy of the Facility Evaluation Report LIC809 has to be posted on the wall and a copy to be given to all parents of currently and newly enrolled children for next 12 months. In addition, copy of LIC9224 Statement Acknowledging Receipt of Licensing Reports need to be signed and kept in child files.

A deficiency is being cited based on the LPA observation, interviews conducted, and record review in accordance with the California Code of Regulations, Title 22. An exit interview was conducted, and Plan of Corrections were reviewed and developed with the Licensee. A copy of this report and appeals rights were discussed and left with the Licensee, Bobbie Rodriguez, whose signature on this form confirm receipt of these documents.

A NOTICE OF SITE VISIT WAS ISSUED, POSTED NEAR THE ENTRANCE TO THE FACILITY, AND MUST REMAIN POSTED FOR 30 DAYS.

SUPERVISORS NAME: Sandy Knight
LICENSING EVALUATOR NAME: Pietro Hernandez
LICENSING EVALUATOR SIGNATURE:	DATE: 10/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/27/2021

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 10/27/2021 02:53 PM - It Cannot Be Edited

Created By: Pietro Hernandez On 10/27/2021 at 02:33 PM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

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

FACILITY NAME: HEARTS AND HANDS CHRISTIAN CHILDCARE AND PRESCHOOL	FACILITY NUMBER: 434408883
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/27/2021

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101229.1(b)

Sign In and Sign Out

(b) The person who brings the child to, and removes the child from, the center shall sign the child in/out. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above in [count] out of [total count] [(objects) (persons)] [identifiers] which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 10/29/2021
	Plan of Correction
1 2 3 4	Director will send to Licensing Office a plan of action on how facility will ensure that parents are signing their children in and out.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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 Knight

LICENSING EVALUATOR NAME:

Pietro Hernandez

LICENSING EVALUATOR SIGNATURE:

DATE: 10/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/27/2021

LIC809 (FAS) - (06/04)

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