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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434410797
Report Date: 07/11/2019
Date Signed: 07/11/2019 04:39:09 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:SHIR HADASH EARLY CHILDHOOD CENTERFACILITY NUMBER:
434410797
ADMINISTRATOR:ADELMAN, ROBINFACILITY TYPE:
850
ADDRESS:20 CHERRY BLOSSOM LANETELEPHONE:
(408) 358-1751
CITY:LOS GATOSSTATE: CAZIP CODE:
95032
CAPACITY:79CENSUS: 15DATE:
07/11/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Robin AdelmanTIME COMPLETED:
12:00 PM
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Licensing Program Analyst (LPA) Zaid Hakim conducted an Unannounced Annual / Random Inspection at the facility today. At the time of the inspection, LPA observed Fifteen (15) preschool age children and at least Five (5) staff engaging in daily activities and met with Ms. Robin Adelman, Director. LPA toured the facility inside and out and observed required postings including but not limited to; the License to operate, Emergency disaster plan (LIC 610) and Notification of Parents Rights (PUB 393). Days and hours of operation are Monday through Friday 7:00am to 6:00pm. LPA toured the facility inside and out and observed required postings including but not limited to; the License to Operate, Emergency Disaster Plan (LIC 610) and Notification of Parents Rights (PUB 393). The facility is licensed to serve a maximum of 79 children ages 2 to 6 in classrooms PS1, PS2, PS3, PS4, PS5, PS9, PS10, and PS11 only. LPA observed the facility to be within ratio and supervision requirements at the time of the inspection.

LPA observed that the facility is operating within the terms of the license and is in compliance with the approved fire clearance capacity. The facility was toured inside and out and was observed to be clean, safe, and in good repair. Disinfectants, cleaning solutions, and all other items that are dangerous to children were observed to be securely stored and inaccessible. Indoor and outdoor activity spaces were observed as properly equipped with age appropriate toys and supplies that are in safe condition. Storage containers for waste have tight fitting covers, the restrooms were observed to be clean and functional, and floors and carpeting are free from hazard and obstruction. The facility serves only snacks and meals are brought from home. The Director stated that parents are informed what foods may be served at any given time via posted menus. The Director stated that all staff are aware of food allergies or dietary restrictions, which are outlined in children's files. LPA discussed staff protocols upon serving food such as; visual observation of all foods and maintaining appropriate temperatures prior to serving. LPA observed cots, pillows, and blankets for napping in the designated napping room. Linens are sent home regularly to be washed. The Director confirmed to LPA that during napping time children's cots are be appropriately spaced throughout the room, allowing for a walkway in between each.

*LPA and the Director discussed children's outside activity time based on weather (heat during summer months, air quality etc.), hydration, supervision, and safety items.

REPORT CONTINUED ON THE FOLLOWING PAGE (PAGE #2 - REPORT DATED 07/11/2019):
SUPERVISOR'S NAME: Anthony StudebakerTELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Zaid HakimTELEPHONE: (408) 497-9236
LICENSING EVALUATOR SIGNATURE:

DATE: 07/11/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2019
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: SHIR HADASH EARLY CHILDHOOD CENTER
FACILITY NUMBER: 434410797
VISIT DATE: 07/11/2019
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CONTINUATION OF PREVIOUS PAGE (PAGE #1 - REPORT DATED 07/11/2019):

LPA toured the outdoor play area, which was observed to be safe and equipped with age appropriate toys, structures, and equipment. There is secure perimeter fencing and the area is physically separate from other outdoor activity areas. The outdoor play areas have direct access from classrooms and are secured from surrounding parking lots and sidewalks. LPA observed that there is sufficient absorbent materials, drinking water available for children via personal water bottles and water fountains, and there is also covering for shade provided by trees and the angle of the building overhang. The Director has been reminded that outdoor water fountains should be wiped down each day. LPA and the Director discussed transition protocol, including direct supervision of children at all times. LPA and the Director discussed the effects and lead in drinking water and LPA provided information.

No weapons are stored on site and no bodies of water are on the premises. LPA observed fire extinguishers, smoke detectors, carbon monoxide detectors, a central alarm system, and complete first aid kits throughout the facility. Emergency disaster drills are performed as required, last of which was done in 04/2019. The facility also maintains written logs of emergency disaster drills and procedures. LPA reviewed a random sample of children's records and observed that there is a separate, complete, and current record for each child. LPA observed that each child record reviewed maintained a valid health screening report, required immunization records, and emergency contact information. The facility maintains a written sign in and out sheet at this time, that is updated throughout the day, containing full signatures from responsible parties. The facility maintains an updated roster of children enrolled in the program. The last fire safety inspection conducted by the local fire authority was in 02/2019 in which detectors, alarm systems, and fire extinguishers were serviced. LPA reminded the Director that all fire safety items and equipment should be maintained at least every 12 months.

A random sample of administration and staff records were reviewed and all teachers and staff maintain valid background clearances. LPA reviewed a random sample of teacher files and observed at least two staff on site maintain valid CPR / First aid certification which expires in 01/2021 and 08/2019. The Director stated that she is aware that there must be at least one staff with current CPR/ First Aid training at all times. LPA confirmed that all staff files reviewed maintained completed Mandated Reporter Training certificates. The facility does not provide transportation to the children. LPA and the Director discussed emergency disaster drills and preparedness, emergency lock-down procedures, children's personal rights including no corporal punishment, forms of discipline, AB 633, healthy beverages in child care, recent updates to the child seat belt law, payment of licensing fees, and surveillance systems in common areas.

The Director has been referred to the department website for Licensing forms, resources, and updates: http://www.cdss.ca.gov/inforesources/Child-Care-Licensing

REPORT CONTINUED ON THE FOLLOWING PAGE (PAGE #3 - REPORT DATED 07/11/2019):
SUPERVISOR'S NAME: Anthony StudebakerTELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Zaid HakimTELEPHONE: (408) 497-9236
LICENSING EVALUATOR SIGNATURE:

DATE: 07/11/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2019
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: SHIR HADASH EARLY CHILDHOOD CENTER
FACILITY NUMBER: 434410797
VISIT DATE: 07/11/2019
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CONTINUATION OF PREVIOUS PAGE (PAGE #2 - REPORT DATED 07/11/2019):

A review of staff records today indicate that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. LPA also discussed and reviewed immunization including Measles, Pertussis, and Influenza. LPA also reminded Licensee 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.

LPA advised the Director of the immunization requirement regarding Senate Bill 792 (pertussis, measles, and flu vaccines) for ALL STAFF THAT WORK DIRECTLY WITH CHILDREN. LPA advised the Director on information regarding lead in drinking water and the affects on children and families, and the required "Mandated Reporter" training that all staff will be required to complete starting January 1, 2018 per AB 1207. LPA referred the Director to the Department website: www.ccld.ca.gov for additional information on the online training and applicable updates as of 2019. https://mandatedreporterca.com/

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 Family Child Care Homes Section 102417. 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

A Notice of Site Visit has been issued and must remain posted for 30 consecutive days.

No Deficiencies have been cited as a result of today's inspection.
Exit interview conducted with Ms. Robin Adelman.
SUPERVISOR'S NAME: Anthony StudebakerTELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Zaid HakimTELEPHONE: (408) 497-9236
LICENSING EVALUATOR SIGNATURE:

DATE: 07/11/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2019
LIC809 (FAS) - (06/04)
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