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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434412404
Report Date: 12/01/2023
Date Signed: 12/04/2023 09:38:15 AM

Document Has Been Signed on 12/04/2023 09:38 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:GATEWAY PRESCHOOL ACADEMYFACILITY NUMBER:
434412404
ADMINISTRATOR:SANDRA KANGFACILITY TYPE:
850
ADDRESS:2360 MCLAUGHLIN AVENUETELEPHONE:
(408) 520-4311
CITY:SAN JOSESTATE: CAZIP CODE:
95122
CAPACITY: 60TOTAL ENROLLED CHILDREN: 36CENSUS: 26DATE:
12/01/2023
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Winnie ShihTIME COMPLETED:
03:50 PM
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On 12/01/2023 at 11:45am, Licensing Program Analyst (LPA), Farida Raja, met with Director, Winnie Shih, for an unannounced Required 3-Year visit and explained the nature of today's inspection. The facility is licensed to serve children ages 2-6 years in five rooms. The facility has one waiver on file for electronic sign in/ out. LPA observed the required posted materials in each classroom and monthly menu near the front entrance to the facility. Days and hours of operation are Monday through Friday, 8:00 am to 5:30 pm.

LPA and director toured the indoor and outdoor areas of the facility and observed the following ratios in each classroom:
Room B101-102: 10 children and 1 teacher
Room B105: not in use
Room 103-104: 11 children and 2 teachers
Room A110-114: 5 children and 1 teacher
Room A 109: storage room for children's supplies

Facility was in compliance with teacher to children ratio requirement during today's inspection. The classrooms, children's restrooms, staff restrooms, and kitchen were inspected. During today's inspection, LPA observed children having lunch. 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 (408-520-4311). Disinfectants, cleaning products and medicines were stored in high cabinets inaccessible to the children in care. 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. LPA observed appropriate changing tables that have raised sides and have vinyl changing pads that are at least 1 inch thick in room A110-114. Napping mats were observed to be appropriate and labelled with each child's name. LPA observed solid waste containers with tight-fitting lids in all classrooms. Restrooms and sinks for children were observed to be safe, sanitary, and in working condition. Staff has one separate bathroom that can be utilized

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SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Farida Raja
LICENSING EVALUATOR SIGNATURE: DATE: 12/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/01/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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: GATEWAY PRESCHOOL ACADEMY
FACILITY NUMBER: 434412404
VISIT DATE: 12/01/2023
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by sick children if needed. LPA observed fire extinguishers, working smoke and carbon monoxide detectors, and fire pull stations. The facility has a built-in smoke detector/ fire system. Log shows that the last Fire Drill was conducted on 9/28/2023 which is compliant with the six-month requirement for facilities.

Drinking water is readily available for children in each room and in the outdoor playground area via individual water bottles which are refilled using water pitchers. 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). Facility did not complete water lead testing prior to their deadline. LPA provide director with a copy of PIN 21-21.1-CCP. LPA referred director to the Department website for lead: Lead Toxicity Prevention and Water Testing Information.

Food is provided by parents and facility does have an option for parents to purchase lunch. Foods and beverages were stored safely to prevent contamination and spoilage. Food storage and preparation areas were observed to be sanitary. All food and beverages that require refrigeration were stored in covered containers at 45F or less. Director stated that the menu is posted monthly on the facility website and an email is sent to parents once it is posted.

Outdoor playgrounds 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 like tan bark and artificial grass to absorb falls. Areas around and under high climbing equipment and slides were cushioned with resilient material. Shaded rest area is provided by trees. LPA observed air conditioning condensers and storage areas were locked and made inaccessible to children. There were no bodies of water observed.

Children sign in and out procedures and logs were reviewed on the Procare app. Children's roster was reviewed, and a copy was provided to the LPA. LPA reviewed ten (10) children's files during today's inspection. Each child's file reviewed contained the required forms.

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SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Farida Raja
LICENSING EVALUATOR SIGNATURE:

DATE: 12/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2023
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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: GATEWAY PRESCHOOL ACADEMY
FACILITY NUMBER: 434412404
VISIT DATE: 12/01/2023
NARRATIVE
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LPA reviwed four (4) staff files during today's inspection. All staff files reviewed contain the required transcripts/verification of experience. At least one staff member on site has a 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). Staff S2 and S3 did not have the required Immunization's against pertussis, measles and influenza/ statement declining influenza vaccine. Staff S3 has not completed the required Mandated Reporter Training. Director had not submitted a new director packet to Child Care Licensing within 10 days of change of director. Director provided new director paperwork to LPA during today's inspection.

Director was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Facility does handle medications and currently has children in care who require Incidental Medical Services and LPA observed the medication is properly stored out of reach of children. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records.For IMS information see PIN 22-02-CCP. LPA observed that medication (epi pen) for child C1 had expired but has not been returned or renewed by facility. Facility has an approved IMS Plan on file with San Jose Regional Office. Isolation of sick child was discussed, and Director stated that sick children will be isolated in the director's office or Room B105 and isolation equipment will be provided. A staff restroom which is off limits to other children is used if necessary. Child is always under visual supervision while in care of the facility.

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/.

Facility does not provide transportation to children except during field trips, but Director understands that children cannot be left alone, unattended in parked vehicles.

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SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Farida Raja
LICENSING EVALUATOR SIGNATURE:

DATE: 12/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2023
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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: GATEWAY PRESCHOOL ACADEMY
FACILITY NUMBER: 434412404
VISIT DATE: 12/01/2023
NARRATIVE
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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

Director provided an updated Emergency Disaster Plan (LIC 610) to LPA during today's inspection.

Five (5) Type B deficiencies were cited today on the attached LIC 809D pages. Appeal rights were printed and provided to Director. LPA reminded Director that failure to correct deficiencies by Plan of Correction Due Date may result in penalties of $100 per day per violation. Exit Interview was conducted, where this report, the citations, plan of corrections, and appeal rights were reviewed and discussed with Director, Winnie Shih.

A NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 DAYS.
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Farida Raja
LICENSING EVALUATOR SIGNATURE:

DATE: 12/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2023
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Document Has Been Signed on 12/04/2023 09:38 AM - It Cannot Be Edited


Created By: Farida Raja On 12/01/2023 at 02:43 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: GATEWAY PRESCHOOL ACADEMY
FACILITY NUMBER: 434412404

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/01/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1597.16(a)(1)
Lead Testing
(1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test.

This requirement is not met as evidenced by:
Deficient Practice Statement
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2
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Based on interview, the licensee did not comply with the section cited above which poses a potential health, safety or personal rights risk to persons in care. Facility has not completed water lead testing by the deadline.
POC Due Date: 12/15/2023
Plan of Correction
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Director will complete water lead testing and submit proof of scheduled testing to LPA by Plan of Correction date of 12/15/2023.
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview and record review, the licensee did not comply with the section cited above for staff S3 which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/15/2023
Plan of Correction
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Director will have staff S3 complete the Mandated Reporter Training and submit proof of completed training to LPA by Plan of Correction date of 12/15/2023.
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:Gladys Kuizon
LICENSING EVALUATOR NAME:Farida Raja
LICENSING EVALUATOR SIGNATURE:
DATE: 12/01/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/01/2023


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Document Has Been Signed on 12/04/2023 09:38 AM - It Cannot Be Edited


Created By: Farida Raja On 12/01/2023 at 02:43 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: GATEWAY PRESCHOOL ACADEMY
FACILITY NUMBER: 434412404

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/01/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.7995(a)(1)
General Provisions and Definitions
(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview and record review, the licensee did not comply with the section cited above for staff S2 and S3 which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/15/2023
Plan of Correction
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Director will submit proof of immunizations for staff S2 and S3 to LPA by Plan of Correction date of 12/15/2023.
Type B
Section Cited
CCR
101226(e)(3)(A)
Health-Related Services
(3) Prescription medications may be administered if all of the following conditions are met: (A) Prescription medications shall be administered in accordance with the label directions as prescribed by the child's physician.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and interview, the licensee did not comply with the section cited above for child C1 which poses a potential health, safety or personal rights risk to persons in care. LPA observed an Epi Pen for child C1 which has expired and has not been returned or renewed by facility.
POC Due Date: 12/15/2023
Plan of Correction
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Director will submit a written plan of how staff will check expiration dates on medications and request renewal or return expired medication to authorized representatives. Director will submit Plan of Correction to LPA by 12/15/2023.
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:Gladys Kuizon
LICENSING EVALUATOR NAME:Farida Raja
LICENSING EVALUATOR SIGNATURE:
DATE: 12/01/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/01/2023


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Page: 6 of 7
Document Has Been Signed on 12/04/2023 09:38 AM - It Cannot Be Edited


Created By: Farida Raja On 12/01/2023 at 02:43 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: GATEWAY PRESCHOOL ACADEMY
FACILITY NUMBER: 434412404

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/01/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101212(b)
Reporting Requirements
(b) The name of the child care center director, and any fully qualified teacher(s) designated to act in the child care center director's absence, shall be reported to the Department within 10 days of a change of child care center director or designee(s).

This requirement is not met as evidenced by:
Deficient Practice Statement
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2
3
4
Based on interview, the licensee did not comply with the section cited above which poses a potential health, safety or personal rights risk to persons in care. Director had not submitted a new director packet to Child Care Licensing within 10 days of change of director.
POC Due Date: 12/15/2023
Plan of Correction
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3
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Director provided new director paperwork to LPA during today's inspection. Director will complete the operations and record keeping orientation and submit proof to LPA by Plan of Correction date of 12/15/2023.
Section Cited
Deficient Practice Statement
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2
3
4
POC Due Date:
Plan of Correction
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2
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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:Gladys Kuizon
LICENSING EVALUATOR NAME:Farida Raja
LICENSING EVALUATOR SIGNATURE:
DATE: 12/01/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/01/2023


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