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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434413119
Report Date: 11/08/2022
Date Signed: 11/08/2022 03:29:18 PM


Document Has Been Signed on 11/08/2022 03:29 PM - 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:SUNFLOWERS MONTESSORI PRESCHOOLFACILITY NUMBER:
434413119
ADMINISTRATOR:CHIA THAOFACILITY TYPE:
850
ADDRESS:668 NORTH FIRST STREETTELEPHONE:
(408) 885-0202
CITY:SAN JOSESTATE: CAZIP CODE:
95112
CAPACITY:40CENSUS: 19DATE:
11/08/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:35 PM
MET WITH:Chia ThaoTIME COMPLETED:
02:40 PM
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Licensing Program Analyst (LPA) Anna Morales conducted an Annual Required Inspection. LPA was greeted by Program Director Chia Thao. Operating hours are from Monday- Friday, 7:30-6:00pm. Last Disaster drill was conducted on 10/31/2022.

LPA observed 19 students, the Director and four teachers. Facility was observed to be in compliance with teacher to child ratio requirement during visit.

Outdoor activity space is enclosed by fencing and is observed to be free of hazards. LPA observed play equipment were in good condition. LPA observed resilient materials under the climbing structures. Drinking water was readily available to children indoor and outdoor. Activities schedule, Breakfast and Lunch Menu and Snack Menu were posted. Facility provides breakfast, lunch and an afternoon snack. LPA observed that food storage areas were clean and free of litter.

The Preschool is located in a two story building. The top floor is used by staff only and there is a barricade in front of the stair case. Inside one of the classrooms. LPA observed a barricade in front of a fire place. LPA Observed age appropriate furnishings

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).
(page 1).
SUPERVISOR'S NAME: Gladys KuizonTELEPHONE: (408) 314-5102
LICENSING EVALUATOR NAME: Anna MoralesTELEPHONE: (408) 334-8325
LICENSING EVALUATOR SIGNATURE:
DATE: 11/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/08/2022
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
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: SUNFLOWERS MONTESSORI PRESCHOOL
FACILITY NUMBER: 434413119
VISIT DATE: 11/08/2022
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LPA observed a fully charged 2A10BC Fire extinguishers in the kitchen and additional larger Fire Extinguisher in the entrance area. The Carbon monoxide is interconnected with the Emergency Fire Alarm. LPA was observed the sign in/sign out procedure. LPA observed a current Children''s Roster.

This facility is providing Incidental Medical Services – IMS Plan. . None of the children currently enrolled are using medication. 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 Child Care Centers Sections 101173 and 101226. 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 (TYY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/chidlqanda.htm

LPA reviewed a random selection of children files. Children records reviewed include Admission Agreement, Identification and Emergency Contact, Consent for Emergency Medical Treatment form, receipt of Parent Rights Notice, Personal Rights Notice, Medical Assessment, Immunization.

LPA reviewed Staff's records reviewed include Criminal Record and Child Abuse Index Clearance, Health Screening Report and TB test, Immunization (Measles, Pertussis, and Flu) record and required Training. LPA reminded Director that the online AB1207 Mandated Reported Training needs to be renewed every two years. There was at least one person with current certification in Pediatric CPR and First Aid present at the facility.
SUPERVISOR'S NAME: Gladys KuizonTELEPHONE: (408) 314-5102
LICENSING EVALUATOR NAME: Anna MoralesTELEPHONE: (408) 334-8325
LICENSING EVALUATOR SIGNATURE:

DATE: 11/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2022
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
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: SUNFLOWERS MONTESSORI PRESCHOOL
FACILITY NUMBER: 434413119
VISIT DATE: 11/08/2022
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Director was reminded that all adults 18 and over, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.


LPA discussed the requirements of AB 633 with the Director and understands the AB 633 fact sheet/copy of Acknowledgement of Receipt of Licensing Reports (LIC 9224). LPA discussed "zero tolerance" related regulations and advised that the assessment of an immediate $500 per day civil penalty for any violation of a "zero tolerance" related regulation. An ongoing civil penalty of $100 per day continues until the violation(s) is corrected.

Exit interview conducted and report was reviewed with the Director Chia Thao. No deficiencies cited at today's visit.

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




To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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
SUPERVISOR'S NAME: Gladys KuizonTELEPHONE: (408) 314-5102
LICENSING EVALUATOR NAME: Anna MoralesTELEPHONE: (408) 334-8325
LICENSING EVALUATOR SIGNATURE:

DATE: 11/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2022
LIC809 (FAS) - (06/04)
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