434412705-10-23-2020-07-CC-SYIP-BUNN38-20201023100551

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434412705
Report Date: 10/23/2020
Date Signed: 10/23/2020 10:06:49 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:	QUEEN OF APOSTLES SCHOOL		FACILITY NUMBER:	434412705
ADMINISTRATOR:	PAUL, SOPHIA		FACILITY TYPE:	850
ADDRESS:	4950 MITTY WAY		TELEPHONE:	(408) 252-3659
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95129
CAPACITY:	40	CENSUS: 0	DATE:	10/23/2020
TYPE OF VISIT:	Case Management - Other	ANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Elizabeth Trela		TIME COMPLETED:	10:05 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	On 10/23/2020 at 9:30AM, Licensing Program Analyst (LPA) Samantha Yip conducted an announced Case Management- Other inspection. Due to COVID-19 and shelter in place, a tele-inspection was conducted via Zoom. LPA met with Ms. Elizabeth Trela, Principal, and explained the reason for the inspection. LPA explained to Ms. Trela that this Facility Evaluation Report (LIC 809) will be emailed to the facility. Facility's reply to the email within 24 hours will serve as acknowledgement and the report was received. The purpose of this inspection was to provide technical assistance in response to a waiver request for 123 school age children to attend the facility due to the spread of COVID-19 in California. Facility is currently licensed to serve ages 3 to 5 years old in the Pre-K Room. A fire clearance for 123 school-age children was granted on 10/08/2020. Ms. Trela guided LPA on a tour of the facility via Zoom. The program plans to operate Monday through Friday from 8AM to 12PM and will serve children in grades kindergarten to 1st grade. Ms. Trela stated the hours of operation will be from Monday through Friday from 8AM to 3PM starting January 2021. Facility plan on conducting daily health screening via ParentSquare app. Children will be drop off/picked up at parking lot. If child/ren become ill during the course of the day, they will be placed in an isolation area located in the Math Lab. The program plans to use the following classrooms at this location: Room 1 and Kindergarten Room. Facility stated that they will have 12 children in a cohort with a maximum of 2 staff. Outdoor activities are planned to take place at the parking lot, courtyard, and grass area adjacent to the playground. ---------------------CONTINUES ON 809 DATED 10/23/2020 PAGE 2----------------------------

SUPERVISOR'S NAME: Anthony Studebaker	TELEPHONE: (408) 324-2148
LICENSING EVALUATOR NAME: Samantha Yip	TELEPHONE: (408) 529-8128
LICENSING EVALUATOR SIGNATURE:	DATE: 10/23/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2020

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: QUEEN OF APOSTLES SCHOOL	FACILITY NUMBER: 434412705
	VISIT DATE: 10/23/2020

NARRATIVE

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-----------------CONTINUATION OF 809 DATED 10/23/2020 PAGE 1-----------------------------

Snacks will be brought from home. The program will ensure that children have access to drinking water at all times.

Medication will not be administered.

The program plans to utilize the following restroom in Geary Hall (2 toilets, 1 urinal, and 2 sinks), which provide for individual privacy.

Sanitizing stations are in place throughout the buildings.

Community Care Licensing will provide on-going Technical Assistance (TA) to Queen of Apostles Schools.

Please feel free to contact the San Jose Child Care Regional Office at (408) 324-2148.

Regional Manager: Carol Marcroft, telephone (408) 324-2150
Licensing Program Manager: Sandy Knight, telephone (408) 324-2151
Licensing Program Manager: Anthony Studebaker, telephone (408) 324-2155
Licensing Program Analyst: Samantha Yip, telephone (408) 529-8128

SUPERVISOR'S NAME: Anthony Studebaker	TELEPHONE: (408) 324-2148
LICENSING EVALUATOR NAME: Samantha Yip	TELEPHONE: (408) 529-8128
LICENSING EVALUATOR SIGNATURE:	DATE: 10/23/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2020

LIC809 (FAS) - (06/04)

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