434412017-9-27-2021-07-CC-MSMS-C79PLL-20210927112454

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434412017
Report Date: 09/27/2021
Date Signed: 09/27/2021 11:25:00 AM

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:	OAK GROVE TAYLOR		FACILITY NUMBER:	434412017
ADMINISTRATOR:	PALAK VYAS		FACILITY TYPE:	850
ADDRESS:	410 SAUTNER DRIVE		TELEPHONE:	(408) 226-0462
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95123
CAPACITY:	50	CENSUS: 0	DATE:	09/27/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Rosario Lozano		TIME COMPLETED:	11:40 AM

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 Analyst (LPA) Mel Matos met with Rosario Lozano, site director, for an unannounced Required - 1 year inspection (KIT 2). LPA toured the Facility both indoor and outdoor areas of the Facility during today's inspection. LPA notes that the Facility is located on the Taylor Elementary School campus (facing Saunter Dr) and is in operation during the calendar school year for the Oak Grove School District. Hours of operation: Monday to Friday from 9 AM to 12 PM. Rosario states that the school district is currently on "fall break" through Friday October 1, 2021 and thus no children were present during today's inspection. The Facility is licensed in Rooms 12A (Blue Room) & 12B (Red Room). LPA observed the required posted materials, including the Facility License, Emergency Disaster Plan (LIC 610), Earthquake Preparedness Checklist (LIC 9148), Parents' Rights Poster (PUB 393), Personal Rights (LIC 613A), Child Car Seat Law (PUB 269), Menus, and Activity Schedule. The program is operated by the Oak Grove School District and all criminal background checks for staff are handled by the CA Department of Education and thus do not come under the jurisdiction of Community Care Licensing Division. LPA reviewed ten children's and six staff files (1 director & 5 teachers) during today's inspection Each child's file reviewed contains the Information and Emergency Information form (LIC 700). All staff files reviewed contain the required transcripts/verification of experience/immunization records and Health Screening Report. All staff have current certificates of completion of the Mandated Reporter Training for Child Care Workers on file. Rosario and three staff have current CPR and First Aid certifications on file. Rosario 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). Rosario states that the Facility operates at a teacher/child ratio of 1:12 when in session. Rosario understands the conditions, limitations, and capacity specifications of the Facility license. Rosario understands that children shall be visually supervised at all times.

SUPERVISOR'S NAME: Diana Stephenson	TELEPHONE: (408) 324-2158
LICENSING EVALUATOR NAME: Melvin S Matos	TELEPHONE: (408) 334-8554
LICENSING EVALUATOR SIGNATURE:	DATE: 09/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2021

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: OAK GROVE TAYLOR	FACILITY NUMBER: 434412017
	VISIT DATE: 09/27/2021

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Any child(ren) who exhibit symptoms of illness including, but not limited to, fever or vomiting, are not accepted in care. Any child(ren) who become ill during the day, shall be isolated in the director’s office area.

LPA observed that the Facility is clean, safe, sanitary, and in good repair for children, staff, and visitors. Rosario states that the Oak Grove School District provides cleaning services Monday to Friday when school is in session. Rosario understands that the Facility must be kept free of flies and other insects & rodents. LPA observed that all furniture and equipment is in good condition and safe for the children. Drinking water is readily available for the children in each Room and in the outdoor playground area via water bottles and disposable cups. LPA observed solid waste containers with tight-fitting lids in each room. Staff and children's bathrooms are clean, sanitary, and operable. There is a separate staff bathroom not utilized by the children which an isolated child can use if needed. Rosario states that there are no weapons or firearms on the premises. The Facility has functioning carbon monoxide detectors.

The food preparation and storage areas are clean, free of litter & rubbish, and free of rodents and other vermin. Snacks are the only meals provided to the children. All food and beverages that require refrigeration are stored in covered containers at 45 degrees F or less. The Facility has trash cans with tight fitting lids for solid waste. Cleaning supplies are inaccessible to the children and are inaccessible to children. Any medications at the Facility are stored in the director's office area.

The playground area utilized by the preschool children is surrounded by appropriate fencing and the outdoor surfaces are safe for the children. The playground area is shared with the preschool age special education & school age program (exempt programs) and kindergarten program. Rosario states that each program has their own use schedules for the playground and she understands that children from different programs cannot commingle with the licensed preschool program. LPA observed that the outdoor equipment is age appropriate and in good condition. Shade is provided by building overhang and canopies in the playground area. There is sufficient resilient materials (wood chips and rubber padding) surrounding the play structure in the playground area. LPA did not observe any bodies of water.

LPA conducted an exit interview with Rosario prior to the conclusion of today's inspection and advised her that no deficiencies issued during today's inspection.
A NOTICE OF SITE VISIT WAS ISSUED, POSTED NEAR THE ENTRANCE TO THE FACILITY, AND MUST REMAIN POSTED FOR 30 DAYS.

SUPERVISOR'S NAME: Diana Stephenson	TELEPHONE: (408) 324-2158
LICENSING EVALUATOR NAME: Melvin S Matos	TELEPHONE: (408) 334-8554
LICENSING EVALUATOR SIGNATURE:	DATE: 09/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2021

LIC809 (FAS) - (06/04)

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