434414643-9-18-2019-07-CC-SCRL-BG5S6Y-20190918133643

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434414643
Report Date: 09/18/2019
Date Signed: 09/18/2019 01:36:50 PM

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:	EARLY CHILDHOOD LEARNING ACADEMY		FACILITY NUMBER:	434414643
ADMINISTRATOR:	ADIDI BOUZIDA		FACILITY TYPE:	850
ADDRESS:	1919 GUNSTON WAY		TELEPHONE:	(408) 314-7060
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95124
CAPACITY:	28	CENSUS: 23	DATE:	09/18/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	11:25 AM
MET WITH:	Adidi Bouzida		TIME COMPLETED:	01:45 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) Stephanie Rangel conducted an Unannounced Annual / Random Inspection at the facility today. LPA toured the facility inside and out and observed required postings including but not limited to; the License to operate, Emergency disaster plan (LIC 610) and Notification of Parents Rights (PUB 393). The facility operates a full day program and days and hours of operation are Monday through Friday 7:00am to 6:00pm. The facility is licensed to serve a maximum of 28 children ages two (2) years old to entry to First Grade in 2 classrooms only. The facility operates on a campus with other licensed programs that are unaffiliated. LPA observed the facility to be in compliance with ratio and supervision requirements at the time of the inspection. The facility was toured inside and out and was observed to be clean, safe, sanitary, and in good repair. The Director stated that there is a janitorial service that cleans daily after program closure. Disinfectants, cleaning solutions, and all other items that are dangerous to children were observed to be securely stored and inaccessible. Indoor and outdoor activity spaces were observed as properly equipped with age appropriate toys and supplies that are in safe condition. The Director stated that outdoor play areas are physically separate and children from other licensed programs are not commingled. Storage containers for waste have tight fitting covers, the restrooms were observed to be clean and functional, and floors and carpeting are free from hazard and obstruction. Food storage areas in the classrooms were clean and supplies were consistent with posted food menus. The facility serves snacks to children and children bring meals from home. Director stated that all staff are aware of food allergies or dietary restrictions, which are outlined in children's files and posted in the classrooms. LPA discussed staff protocols upon serving food such as; visual observation of all foods and maintaining appropriate temperatures prior to serving. LPA observed cots, pillows, and blankets for napping and a changing table within arms reach of a sink. The Director has been referred to the department website for Licensing forms, resources, and updates: http://www.cdss.ca.gov/inforesources/Child-Care-Licensing REPORT CONTINUED ON THE FOLLOWING PAGE (PAGE #2 - REPORT DATED 09/18/2019):

SUPERVISOR'S NAME: Anthony Studebaker	TELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Stephanie C Rangel	TELEPHONE: (408) 334-8556
LICENSING EVALUATOR SIGNATURE:	DATE: 09/18/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2019

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: EARLY CHILDHOOD LEARNING ACADEMY	FACILITY NUMBER: 434414643
	VISIT DATE: 09/18/2019

NARRATIVE

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CONTINUATION OF PREVIOUS PAGE (PAGE #1 - REPORT DATED 09/18/2019):

No weapons are stored on site and no bodies of water are on the premises. LPA observed fire extinguishers, smoke detectors, carbon monoxide detectors, a central alarm system, and complete first aid kits throughout the facility. Emergency disaster drills are performed as required, last of which was done on 08/28/2019. The facility also maintains posted logs of emergency disaster drills and procedures. LPA reviewed a random sample of children's records and observed that there is a separate, complete, and current record for each child enrolled in the center. LPA observed that each child record reviewed maintained a valid health screening report, required immunization records, and emergency contact information. The facility maintains a sign in and out sheet, that is updated throughout the day, containing full signatures from responsible parties. The facility maintains an updated roster of children enrolled in the program.

A random sample of administration and staff records were reviewed and all teachers and staff maintain valid background clearances. LPA reviewed a random sample of teacher files and observed at least one staff on site maintains valid CPR / First aid certification which expires in 02/2020. The Director stated that they are aware that there must be at least one staff with current CPR/ First Aid training at all times. The facility does not provide transportation to the children.

LPA toured the outdoor play area, which was observed to be safe, equipped with age appropriate toys and equipment, and in good condition. There is secure perimeter fencing and the area is physically separate from all other outdoor activity areas. LPA observed that there is sufficient absorbent materials, drinking water available for children via personal water bottles and water fountains, and there is also sufficient covering for shade.

A review of staff records today indicate that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. LPA also discussed and reviewed immunization including Measles, Pertussis, and Influenza. LPA also reminded Licensee of the applicable civil penalties for those adults who have not received fingerprint clearances, are not associated to the license and who come in contact with or provide care and supervision to the children. Penalty amounts: $100.00 per person per day, minimum of $100.00 to a maximum of $500.00 per person for an initial violation and a minimum of $100.00 to a maximum of $3000.00 per person for any subsequent violation within a 12 month period.
REPORT CONTINUED ON THE FOLLOWING PAGE (PAGE #3 - REPORT DATED 09/18/2019):

SUPERVISOR'S NAME: Anthony Studebaker	TELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Stephanie C Rangel	TELEPHONE: (408) 334-8556
LICENSING EVALUATOR SIGNATURE:	DATE: 09/18/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2019

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: EARLY CHILDHOOD LEARNING ACADEMY	FACILITY NUMBER: 434414643
	VISIT DATE: 09/18/2019

NARRATIVE

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CONTINUATION OF PREVIOUS PAGE (PAGE #2 - REPORT DATED 09/18/2019):

This facility provides Incidental Medical Services – IMS. 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 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

Revised IMS plan to be sent to CCL by 10/8/19.

Effect of Lead Exposure handout dated 1/20/19 given during today’s inspection. Licensee understands that per Assembly Bill (AB 2370), written information regarding lead exposure needs to be given out to enrolling and re-enrolling parents or guardians.

A Notice of Site Visit has been issued and must remain posted for 30 consecutive days.

No deficiencies have been cited as a result of today's inspection.
Exit interview conducted with Ms. Adidi Bouzida, Director.

SUPERVISOR'S NAME: Anthony Studebaker	TELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Stephanie C Rangel	TELEPHONE: (408) 334-8556
LICENSING EVALUATOR SIGNATURE:	DATE: 09/18/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2019

LIC809 (FAS) - (06/04)

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