434414117-12-15-2022-07-CC-AALZ-CM5MYS-20221215090157

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434414117
Report Date: 12/14/2022
Date Signed: 12/15/2022 09:02:32 AM

Document Has Been Signed on 12/15/2022 09:02 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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME:	CHRISTOPHER STATE PRESCHOOL		FACILITY NUMBER:	434414117
ADMINISTRATOR:	CARMODY, BARBARA		FACILITY TYPE:	850
ADDRESS:	565 COYOTE ROAD		TELEPHONE:	(408) 573-3341
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95111
CAPACITY: 24	TOTAL ENROLLED CHILDREN: 24	CENSUS: 8	DATE:	12/14/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Blankenship, Rocio		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	On this day Licensing Program Analyst/s (LPA/s) Almaraz, Celi conducted an unannounced annual random inspection. Due to COVID- 19 precautionary measures were taken. This facility is currently licensed for a capacity of 24. Licensing staff met with Director Blankenship, Rocio and explained the nature of today’s inspection. This is a preschool half day (AM/PM) program that currently operates from 8AM to 11 AM, and 12:15 PM to 3:15 PM, Monday thru Friday. Licensing staff was taken on a guided tour of the facility of both indoors and outdoors. At the initial start of this visit, there was a total census of 8 preschoolers and a total census of four staff, including one Director, and four teachers present. This program is on the Christopher elementary school campus. Physical Plant: All areas identified on the Facility Sketch were inspected. This preschool program consists of the following classrooms: PK 1-This classroom is unofficially called the Christopher AM this classroom, currently operates as an AM program only, from 8AM to 11 AM, due to low enrollment this class operates no more than 4 hours per day. During full enrollment, classes are divided into two sessions, no more than 4 hours per day. Per Director a PM class will be operating based enrollment needs. PK 2-Due to low enrollment this classroom is being used as a staffroom. The Director understands that this area will need to cleared out if there is enrollment for this room to be used for children. This room has access to one sink. There is a gate separating the classrooms. LPA observed the following: Staff # 1-3 fully qualified teachers with 8 preschool children. Teacher child ratios were observed, and staff names recorded. Personal rights observed. There is access to two sinks inside the class. There are two faucets that are capped off. The two rooms are adjacent to one another, with two centralized lavatories in between. All classrooms observed to have suitable furniture and equipment, which were inspected for age appropriateness. All classrooms observed to have sufficient have telephone services, heating, lighting, and ventilation. 1/5

SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Araceli Almaraz
LICENSING EVALUATOR SIGNATURE:	DATE: 12/14/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2022

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: CHRISTOPHER STATE PRESCHOOL	FACILITY NUMBER: 434414117
	VISIT DATE: 12/14/2022

NARRATIVE

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General sanitization & safety: Preschoolers have their own cubby to store their belongings. Per Director, sick children are isolated in the staff area in accordance with Santa Clara county Public Health guidelines. The area will then be disinfected by the custodian. LPA advised Director that all storage containers for solid waste, including moveable trash receptacles must have tight-fitting covers that are kept on, and in standard condition, LPA observed there to be foot petals to open trash bins. General sanitation was observed. Availability of indoor drinking water was observed in classrooms. Disinfectants, cleaning solutions, medication and other hazardous items that pose a risk to children, were inaccessible to the children in care, locked in upper cabinets. Director states that poisons are kept with the custodian. No bodies of water or other hazards were observed during inspection. Director understands that smoking is prohibited. Per Director there are no firearms on site.

Kitchen: All kitchen areas/food preparation and food storage areas are kept clean and are free of litter, rubbish, rodents, and/or any other vermin. Water and refrigerator temperatures in standard condition. Director states waste is to be discarded immediately after each meal.

Food: Menus are posted on site one month in advance, in the classroom. Menus for the past one year are available upon request. Facility provides Snacks (AM/PM). LPA reviewed food for availability, quantity and appropriateness to children in care. Per Director, all meals are prepared daily at Kidango’s head office (Freemont) and transported to facility. Facility has a food contract with Kidango. Snacks and supplemental food with 5 components kept on site. LPA observed there is an allergy list posted in kitchen area. There is a name to face and allergy, system posted in kitchen area for best practice. Director states there currently no children enrolled that have allergies. Per Director no nuts are allowed on site. No food from home is allowed. LPA observed snacks placed in containers.

Lavatories: There are two children's lavatories, beside one another, in proximity to each classroom. There are two toilets in the PK 1 lavatory with no sink. The children wash their hands in the classroom. PK-2 has a lavatory that has one toilet and one sink, this is currently being used as a staff lavatory, or for a sick child if needed. During full enrollment staff will use the elementary staffroom lavatory, and will still be used as an isolation lavatory. There is access to three toilets in total, one sink in lavatory and three additional sinks. All surfaces accessible to children are toxic free. All toilets and hand washing facilities are in safe and sanitary operating conditions.

Outdoor Playground: Equipment is in safe condition, free of sharp, defective or pointed parts. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. There is no high climbing equipment, swings, slides, and similar equipment. The children use tricycles, balls, water play, easel paining and other manipulatives. There is adequate shade in the play yard. 2/5

SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Araceli Almaraz
LICENSING EVALUATOR SIGNATURE:	DATE: 12/14/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2022

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: CHRISTOPHER STATE PRESCHOOL	FACILITY NUMBER: 434414117
	VISIT DATE: 12/14/2022

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Availability of outdoor drinking water was observed. There is a mobile sand table that is kept inside. Director states that if used outside it will be covered and brought inside. There is a locked closet for storage in PK-2, where custodial supplies are kept.

Facility Records: All staff have received an active criminal record clearance as a condition of their employment with the Santa Clara County office of Education, (San Jose Unified School District).
LPA did not conduct a full review staff files during the inspection. The staff files are stored at the administrative office and electronically. The files are available to be printed upon request. In the event of a power outage there is a backup system, files will be brought from main office to the facility. LPA was able to confirm that at least one staff (Director) has record of CPR and First Aid, valid until 03/06/2023. Director has a Directors permit valid thru 11/01/2027. LPA confirmed all staff present have the following: MMR & Tdap vaccinations, flu vaccine or the opt out. Per Director all staff has completed Mandated Reporter Training, Director’s training valid thru 08/11/2024. Directors understand this must be renewed every two years. LPA confirmed all staff present also have Mandated Reporter Training.

LPA observed that two staff present have valid teachers permits. LPA did review children's 2 files. The children's files are being stored at the administrative office and electronically. The files are available to be printed upon request. In the event of a power outage there is a backup system, files will be brought from main office to the facility.

Supervision: All children were observed to be under visual supervision of a teacher at all times.

Sign in and out: Procedures were reviewed by LPA/s to ensure that children who are present where sign in. Facility uses an electronic sign in/sign out system. LPAs obtained a roster and personnel report at the conclusion of this inspection.

Waivers: There are no known waivers of file. Director did present an email from Regional Manager (RM) Studebaker confirming electronic files are permitted,

Medical & First Aid Supplies: There is a first aid kit in each classroom, kept in a fanny within a backpack. LPA reviewed kit to ensure supplies are complete. Director states that supplies are checked every month. Per Director medication is only administered to a child when accompanied with a doctor's note, parent plan, authorizations are to be completed monthly. Any medication is kept in a locked cabinet and/or in emergency backpack when outside (at least six feet high) which is stored out of reach of children. 3/5

SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Araceli Almaraz
LICENSING EVALUATOR SIGNATURE:	DATE: 12/14/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2022

LIC809 (FAS) - (06/04)

Page: 3 of 5

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: CHRISTOPHER STATE PRESCHOOL	FACILITY NUMBER: 434414117
	VISIT DATE: 12/14/2022

NARRATIVE

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Per Director there are currently no children enrolled who required Incidental Medical Services (IMS). Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department.

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

Fire & Safety: Carbon monoxide detectors and smoke detectors are working and present in the facility, the fire department conducted a fire inspection on 09/24/2022. There are Fire extinguishers, size 3A40BC in each room, last serviced 09/24/2022; a last fire drill was conducted on 12/09/2022. Director understands this is to be completed every six months.

Matts and cots: There is currently no napping at the half day program. There is a seat for a sick child to rest on.

Lead Testing: Director states a certified external water sampler took a sample on 10/28/2022 and 10/29/2022. Per Director, the results came back negative on 11/07/2022, Director submitted the LIC 9275, a completed signed and dated childcare sampling checklist form LIC 9276 and a facility sketch, LIC 999 fully labeled with locations of all water outlets to their LPA and self-report testing results. As a safety measure, Director has currently capped off any drinking fountains indoor and outdoor.

LPA advised Director to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov. For commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

Postings: Parent’s Rights Poster (with complaint Hotline) was observed during this inspection. LPA observed all required postings, including license and emergency disaster plan. LPA and Director discussed updating relocation site off premises in the event of an emergency, Director will fill out form and post on or by the end of the day and email a copy to licensing.

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. 4/5

SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Araceli Almaraz
LICENSING EVALUATOR SIGNATURE:	DATE: 12/14/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2022

LIC809 (FAS) - (06/04)

Page: 4 of 5

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: CHRISTOPHER STATE PRESCHOOL	FACILITY NUMBER: 434414117
	VISIT DATE: 12/14/2022

NARRATIVE

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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

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.

SB792 (Immunization Requirements for Staff and Employees) was discussed with the facility representative.

AB1207 Mandated Child Abuse Reporting – On or before March 30, 2018 any person who works in a childcare facility shall complete the training and renew the training every 2 years. Website provided: https://www.mandatedreporterca.com/training/child-care-providers

The following was discussed:
· Reporting Requirements.
· The facility shall ensure that each child is accorded the following personal rights: to be accorded safe, healthful and comfortable accommodations.
· All personnel shall be in good health and shall be physically and mentally capable of performing assigned tasks; personnel that pose a threat to the health and safety of children shall be relieved of their duties.All personnel shall be given on the job training in housekeeping, sanitation principles and universal health precautions.

The following was discussed: 1. The Director must ensure that a Director packet was submitted for the 4 facilities that Director overseas, this includes this facility, and Snell State Preschool, 434412407, each location has a a teacher with a valid site Directors permit. Director understands that failure to do so may result in a citation. 2. LPA and Director discussed updating relocation site off premises in the event of an emergency, Director will fill out form and post on or by the end of the week and email a copy to LPA.

LPA advised the facility representative to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov.

There are NO deficiencies being cited in accordance with Title 22 of the California Code of Regulations and Health & Safety codes.

A notice of site visit was issued and must remain posted for 30 consecutive days.

Exit interview conducted and report was reviewed with facility representative 5/5

SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Araceli Almaraz
LICENSING EVALUATOR SIGNATURE:	DATE: 12/14/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2022

LIC809 (FAS) - (06/04)

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