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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434413153
Report Date: 06/29/2022
Date Signed: 03/08/2023 11:30:06 AM

Document Has Been Signed on 03/08/2023 11:30 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:BRIGHTSTAR CHRISTIAN ACADEMY PRESCHOOLFACILITY NUMBER:
434413153
ADMINISTRATOR:JACQUELINE ALKHASEHFACILITY TYPE:
850
ADDRESS:1513 KOOSER ROADTELEPHONE:
(408) 266-7600
CITY:SAN JOSESTATE: CAZIP CODE:
95118
CAPACITY: 97TOTAL ENROLLED CHILDREN: 48CENSUS: 39DATE:
06/29/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:55 AM
MET WITH:Jacqueline AlkhasehTIME COMPLETED:
01:15 PM
NARRATIVE
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Licensing Program Analyst (LPA), Joe Macias, conducted an unannounced Case Management Inspection in response to an unusual incident that the facility self reported to Community Care Licensing (CCL). LPA met with the Director Jacqueline Alkhaseh, and explained the nature of today's inspection to her. There were 39 preschool age children at the facility today along with 5 fully qualified teachers, and 2 assistant teachers.

This visit was made to inquire about an unusual incident that occurred on June 13, 2022.

During today's visit LPA Macias toured the facility, interviewed staff, reviewed the facility's supervision policy, and obtained copies of pertinent information. Based on staff interviews, as well as the self reported incident report; a child was left behind on the playground for an unknown amount of time.

Prior to today's inspection the Director held a training reviewing the facility's supervision policy. The employee involved in the incident has been terminated, and the center self reported the incident.

As a result of this visit, a type A deficiency was cited.

Appeal right were printed and reviewed with the staff.

Deficiencies cited, exit interview conducted, and a copy of this report was provided and reviewed with the Director Jacqueline Alkhaseh.

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

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Joseph Macias
LICENSING EVALUATOR SIGNATURE: DATE: 03/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/08/2023
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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Document Has Been Signed on 03/08/2023 11:30 AM - It Cannot Be Edited


Created By: Joseph Macias On 03/08/2023 at 10:19 AM
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: BRIGHTSTAR CHRISTIAN ACADEMY PRESCHOOL
FACILITY NUMBER: 434413153

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/29/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
06/29/2022
Section Cited
CCR
101229(a)(1)

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Responsibility For Providing Care and Supervision - Title 22 regulations state a licensee shall provide care and supervision as necessary to meet the needs of each child, and no child shall be without supervision of a teacher at any time. This includes visual observation.
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A review of the regulation, as well as a staff training was provided that will focused on care & supervision, including constant visual supervision of children while outside 100% of the time. Proof of attendance obtained.
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Based on staff interviews, as well as the self reported incident report; a child was left behind at the playground for an unknown amount of time. Prior to today's inspection the Director held a training reviewing the facility's supervision policy. The employee involved in the incident has been terminated, and the center self reported the incident.
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AB 633 states upon receipt, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months and it is to be signed and kept in each child’s file.

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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:Joseph Macias
LICENSING EVALUATOR SIGNATURE:
DATE: 03/08/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/08/2023


LIC809 (FAS) - (06/04)
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