434414441-9-10-2021-07-CC-JCRZ-C6QULA-20210910154026

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434414441
Report Date: 09/10/2021
Date Signed: 09/10/2021 03:40:31 PM

Document Has Been Signed on 09/10/2021 03:40 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:	EDUCARE CALIFORNIA AT SILICON VALLEY HEADSTART/PS		FACILITY NUMBER:	434414441
ADMINISTRATOR:	MY NGUYEN-SOY		FACILITY TYPE:	850
ADDRESS:	1399 SANTEE DRIVE		TELEPHONE:	(408) 573-3340
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95122
CAPACITY: 173	TOTAL ENROLLED CHILDREN: 0	CENSUS: 85	DATE:	09/10/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:35 AM
MET WITH:	My Nguyen-Soy		TIME COMPLETED:	04:00 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), Janette Cruz met with Site supervisor My Nguyen-Soy for an unannounced annual Required 1-Year inspection as well as to conduct an inspection for the request for shared playground waiver at the facility. LPA explained the nature of today's visit to the Site Supervisor. LPA toured the facility both indoor and outdoor during today's visit. LPA notes that the facility is licensed in the Preschool classrooms:163, 167, 168, 173, 178, 183, 141 and 146 and Toddler option classrooms : 140 and 136. 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), Child Car Seat Law (PUB 269), Menus, and Activity Schedule. The facility has an active waiver on file (use of I-pad and server technology system for electronic sign-in and sign-out of children) and is in compliance with the conditions of the waiver. Clearances for individuals at this facility who require caregiver background checks are issued by the State Dept. of Education and/or County Office of Education and do not come under the jurisdiction of Community Care Licensing division. LPA reviewed ten children's files and seven staff files (1 director and 6 teachers) during today's inspection. Each child's file reviewed contains the Information and Emergency Information form (LIC 700) and medical assessment. Sign in and sign out sheets were reviewed and were in compliance, including legal signatures. All staff files reviewed contain the required transcripts/verification of experience/immunization records and Health Screening Report (LIC 501). All staff have current certificates of completion of the Mandated Reporter Training for Child Care Workers on file. REPORT CONTINUED ON THE FOLLOWING PAGE (PAGE #2):

SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Janette Cruz
LICENSING EVALUATOR SIGNATURE:	DATE: 09/10/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2021

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: EDUCARE CALIFORNIA AT SILICON VALLEY HEADSTART/PS	FACILITY NUMBER: 434414441
	VISIT DATE: 09/10/2021

NARRATIVE

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LPA observed the staff immunization records per SB792 requirement are kept in the Educare Human Resources Department. All teachers and the Director have current CPR and First Aid certifications on file. Director understands that there shall be at least one person, with valid CPR and First Aid 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 inspection. Director understands the conditions, limitations, and capacity specifications of the Facility license. Director understands that children shall be visually supervised at all times. Any child(ren) who exhibit symptoms of illness including, but not limited to, fever or vomiting, are not accepted in care. Facility has a designated room where a child(ren) can be isolated if exhibiting signs of illness and isolation equipment is provided. Director states that the Facility has adequate cleaning/sanitizing supplies & PPE equipment.

LPA observed that the Facility is clean, safe, sanitary, and in good repair for children, staff, and visitors. Director understands that the Facility must be kept free of flies and other insects & rodents. LPA observed that all furniture and equipment are in good condition and safe for the children. Drinking water is readily available for the children in the Facility and in the outdoor playground area via water pitchers/disposable cups. 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. Director states that there are no weapons or firearms on the premises. The Facility has working smoke and carbon monoxide detectors.

LPA observed that the food preparation and storage areas are clean, free of litter & rubbish, and free of rodents and other vermin. All food and beverages that require refrigeration are stored in covered containers at 45 degrees F or less. The Facility has trash cans with tight fitting lids for solid waste. Cleaning supplies are inaccessible to the children and stored in

REPORT CONTINUED ON THE FOLLOWING PAGE (PAGE #3):

SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Janette Cruz
LICENSING EVALUATOR SIGNATURE:	DATE: 09/10/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2021

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: EDUCARE CALIFORNIA AT SILICON VALLEY HEADSTART/PS	FACILITY NUMBER: 434414441
	VISIT DATE: 09/10/2021

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locked cabinets/high shelves inaccessible to children. Director states that there are no poisons in the Facility. Director states that the Facility does not administer medication at this time. Director also states that the Facility does not provide transportation.

LPA observed that the playground is surrounded by appropriate fencing, has locked storage, and has shade provided by umbrellas and trees. No bodies of water were observed in both playgrounds during today's inspection. The areas of the playground has grass and wood chips for resilient materials. LPA obtained photos of playground areas that are requested by facility to be shared with transition Kindergarten classrooms operated by Franklin McKinley School District.

Licensing Forms, Title 22 Regulations and information can be obtained through the internet at www.cdss.ca.gov.

LPA conducted an exit interview with the Director prior to the conclusion of today's inspection and advised her that no deficiencies are issued during today's inspection.

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

SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Janette Cruz
LICENSING EVALUATOR SIGNATURE:	DATE: 09/10/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2021

LIC809 (FAS) - (06/04)

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