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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434408883
Report Date: 10/26/2022
Date Signed: 01/23/2023 11:42:03 AM


Document Has Been Signed on 01/23/2023 11:42 AM - It Cannot Be Edited

Document is an Amendment of Original Document on 10/26/2022 02:52 PM

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

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Licensing Program Analysts (LPA) Pete Hernandez conducted an unannounced Required 1 Year inspection. LPA met with Ms. Bobbie Rodriguez, Director, and explained the reason of the inspection. Present during the inspection were 31 preschool children and 4 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

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. LPA 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 09/30/22. Director stated that there are no weapons stored on the premises.

The outside area is fenced. Play structure was observed to in excellent 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 10/26/2022 page 2----------------------------------------
SUPERVISOR'S NAME: Gladys KuizonTELEPHONE: (408) 314-5102
LICENSING EVALUATOR NAME: Pietro HernandezTELEPHONE: (408) 598-9250
LICENSING EVALUATOR SIGNATURE:
DATE: 10/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/24/2022
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: HEARTS AND HANDS CHRISTIAN CHILDCARE AND PRESCHOOL
FACILITY NUMBER: 434408883
VISIT DATE: 10/26/2022
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---------------------continuation of 809 dated 10/26/2022 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 all required documentation. 4 Staff files were reviewed and all the required documentation was included in the files.

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 10/25/24. 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.
SUPERVISOR'S NAME: Gladys KuizonTELEPHONE: (408) 314-5102
LICENSING EVALUATOR NAME: Pietro HernandezTELEPHONE: (408) 598-9250
LICENSING EVALUATOR SIGNATURE:

DATE: 10/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/26/2022
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
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: HEARTS AND HANDS CHRISTIAN CHILDCARE AND PRESCHOOL
FACILITY NUMBER: 434408883
VISIT DATE: 10/26/2022
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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 NOT 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.
SUPERVISOR'S NAME: Gladys KuizonTELEPHONE: (408) 314-5102
LICENSING EVALUATOR NAME: Pietro HernandezTELEPHONE: (408) 598-9250
LICENSING EVALUATOR SIGNATURE:

DATE: 10/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/26/2022
LIC809 (FAS) - (06/04)
Page: 3 of 3