434412407-1-30-2020-07-CC-DMAC-BLC2UR-20200130164245

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434412407
Report Date: 01/30/2020
Date Signed: 01/30/2020 04:42:50 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:	SNELL STATE PRESCHOOL/HEAD START		FACILITY NUMBER:	434412407
ADMINISTRATOR:	JUDY BUGRIN		FACILITY TYPE:	850
ADDRESS:	3550 SNELL ROAD		TELEPHONE:	(408) 573-3340
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95136
CAPACITY:	72	CENSUS: 53	DATE:	01/30/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	12:35 PM
MET WITH:	Rocio Blankenship		TIME COMPLETED:	04:50 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 Analyst (LPA) Dung Mac and Licensing Program Manager, Diana Stephenson, conducted an unannounced annual random inspection to the facility today. LPA met with Rocio Blankenship, Site Supervisor, and explained the nature of today's visit to her. The Facility is licensed in rooms 1, 2, and 3 at the Santa Clara County Office of Education. LPA toured the Facility both inside and outside for today's inspection. 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, Menus, and Activity Schedule. LPA reviewed six children's files and five staff files consisting of 1 site supervisor, 2 substitute (1 teacher and 1 teacher assistant), and 2 teacher files during today's inspection. All staff and children's files were complete. Three staff have current CPR and First Aid certifications on file. Rocio 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). The facility is a Title V program and fingerprints with the department of education. LPA observed that the teacher/child ratio was in compliance during today's visit. LPA observed 17 preschool children with one teacher and two assistants in Room #1. LPA observed 18 sleeping preschool children with one assistant and one site supervisor in Room #2. LPA observed 18 sleeping preschool children with one teacher and two assistants in Room #3. Rocio understands the conditions, limitations, and capacity specifications of the Facility license. Rocio understands that children shall be visually supervised at all times. LPA observed that all rooms are clean and safe for all children and staff. Drinking water is readily available for the children in each room via faucet and in the outdoor playground area via water dispensers/disposable cups. Continued on Page #2

SUPERVISOR'S NAME: Diana Stephenson	TELEPHONE: (408) 324-2158
LICENSING EVALUATOR NAME: Dung Mac	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR SIGNATURE:	DATE: 01/30/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/30/2020

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: SNELL STATE PRESCHOOL/HEAD START	FACILITY NUMBER: 434412407
	VISIT DATE: 01/30/2020

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LPA observed solid waste containers with tight-fitting lids in the facility. Staff and children's bathrooms are clean, sanitary, and operable. There are one separate staff bathrooms not utilized by the children and another bathroom used for parent/volunteers. Rocio states that there are no weapons or firearms on the premises.

The food is brought by Revolution Foods on Monday-Friday. Staff prepares breakfast, snack, and lunch for Rooms 2 & 3, and snack for Room 1 for AM and PM class. Cleaning supplies are inaccessible to the children and stored in high cabinets. Any poisons are stored in locked storage inaccessible to children. No medication is being administered by the Facility at this time. Incidental Medical Services (IMS) 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.

LPA observed all furniture and equipment is in good condition and safe for the children. The playground area utilized by children is surrounded by appropriate fencing and the outdoor surfaces are safe for the children. LPA observed that the outdoor equipment is age appropriate and in good condition. LPA observed a canopy and several trees which provide shade for the day care children. LPA did not observe any bodies of water.

LPA conducted an exit interview with the Rocio. No deficiencies were cited during visit.

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

SUPERVISOR'S NAME: Diana Stephenson	TELEPHONE: (408) 324-2158
LICENSING EVALUATOR NAME: Dung Mac	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR SIGNATURE:	DATE: 01/30/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/30/2020

LIC809 (FAS) - (06/04)

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