434413153-3-4-2022-07-CC-OCAO-CC7TQH-20220304135600

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434413153
Report Date: 03/04/2022
Date Signed: 03/04/2022 01:56:07 PM

Document Has Been Signed on 03/04/2022 01:56 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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME:	BRIGHTSTAR CHRISTIAN ACADEMY PRESCHOOL		FACILITY NUMBER:	434413153
ADMINISTRATOR:	JACQUELINE ALKHASEH		FACILITY TYPE:	850
ADDRESS:	1513 KOOSER ROAD		TELEPHONE:	(408) 266-7600
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95118
CAPACITY:	97	CENSUS: 37	DATE:	03/04/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:45 AM
MET WITH:	Jacqueline Alkhaseh		TIME COMPLETED:	02:00 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) Ofelia Calivo met with Director Jacqueline Alkhaseh for an unannounced Required - 1 Year inspection of the preschool today. LPA toured the indoor and outdoor areas of the facility with Jacqueline during today's inspection. LPA observed the required posted materials including: The Facility License, Menus, Child Passenger Restraint System Poster (PUB 269), Notification of Parents’ Rights (PUB 393), Emergency Disaster Plan (LIC 610), Personal Rights (LIC 613A), Earthquake Preparedness Checklist (LIC 9148), Disaster and Fire Drills Log, and Activity Schedule. The facility has an active waiver for electronic sign in/out. There are two buildings at the facility. Preschool operates from 8:00am to 5:00pm in Building 2. LPA reviewed nine children and seven staff files (Director and 6 Teachers) during today's inspection. Each child's file reviewed contains the Information and Emergency Information form (LIC 700) and all required licensing forms. 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. All staff have current CPR and First Aid certifications on file. Jacqueline understands that there shall be at least one person, with valid First Aid and CPR certifications, on site at all times or present during off-site activities (field trips). LPA observed that the teacher/child ratio was in compliance during today’s visit. Jacqueline understands the conditions, limitations, and capacity specifications of the Facility license. Jacqueline understands that children shall be visually supervised at all times. LPA observed that all rooms are clean and safe for all children and staff. Jacqueline states that the facility has a third-party cleaning service that cleans the facility Monday through Friday in the evenings. Drinking water is readily available for the children in each room and in the outdoor playground area via water bottles, drinking fountains and water dispensers. LPA observed solid waste containers with tight-fitting lids in each room and in the playground areas. 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. Jacqueline states that there are no weapons on the premises.

SUPERVISOR'S NAME: Diana Stephenson	TELEPHONE: (408) 324-2128
LICENSING EVALUATOR NAME: Ofelia Calivo	TELEPHONE: (408) 334-8551
LICENSING EVALUATOR SIGNATURE:	DATE: 03/04/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2022

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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: BRIGHTSTAR CHRISTIAN ACADEMY PRESCHOOL	FACILITY NUMBER: 434413153
	VISIT DATE: 03/04/2022

NARRATIVE

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The food preparation area is adequately equipped with an oven, a microwave oven, a refrigerator, and hot and cold running water. There is also adequate food for snacks for the children. Children bring their own lunch. Cleaning supplies and any poisons are stored inaccessible to the children. Any medications at the Facility are stored appropriately and in the director's office. LPA reviewed the medication lock box during today’s visit. Currently there are no children that need medication and no current medicine log.

LPA observed all furniture and equipment is in good condition and safe for the children. The playground areas 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. There are also sufficient resilient materials (tan barks and sand) in the outdoor playground area. LPA did not observe any bodies of water.

This facility is not providing Incidental Medical Services – IMS at this time. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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. Jacqueline states that the Facility does not administer any medication at this time.

Jacqueline 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.

SUPERVISOR'S NAME: Diana Stephenson	TELEPHONE: (408) 324-2128
LICENSING EVALUATOR NAME: Ofelia Calivo	TELEPHONE: (408) 334-8551
LICENSING EVALUATOR SIGNATURE:	DATE: 03/04/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2022

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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: BRIGHTSTAR CHRISTIAN ACADEMY PRESCHOOL	FACILITY NUMBER: 434413153
	VISIT DATE: 03/04/2022

NARRATIVE

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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/process.

Exit interview conducted and report was reviewed with the Director Jacqueline Alkhaseh.
A notice of site visit was given and must remain posted for 30 days.

SUPERVISOR'S NAME: Diana Stephenson	TELEPHONE: (408) 324-2128
LICENSING EVALUATOR NAME: Ofelia Calivo	TELEPHONE: (408) 334-8551
LICENSING EVALUATOR SIGNATURE:	DATE: 03/04/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2022

LIC809 (FAS) - (06/04)

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