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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434414756
Report Date: 09/29/2022
Date Signed: 09/29/2022 05:08:39 PM

Document Has Been Signed on 09/29/2022 05:08 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
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:SAN JOSE GRAIL FAMILY SERVICESFACILITY NUMBER:
434414756
ADMINISTRATOR:JUANA CASTILLOFACILITY TYPE:
850
ADDRESS:2003 E. SAN ANTONIO STREETTELEPHONE:
4083477892
CITY:SAN JOSESTATE: CAZIP CODE:
95116
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 9DATE:
09/29/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:09 PM
MET WITH:Anarita Reyes TIME COMPLETED:
05:10 PM
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Licensing Program Analysts (LPA) Stephanie Collins conducted an unannounced Annual inspection of the Preschool. LPA met Program Director Anarita Reyes and informed her the purpose of the visit. Facility's License, Notification of Parents’ Right Poster, Child Car Seat Law, and LIC613A Personal Rights were observed to be posted. The Preschool operates two sessions Monday through Friday. The AM session runs from 08:30 AM to 11:30 AM and the PM session runs from 01:00 PM to 04:00 PM. LPA observed There 9 children and 3 staff supervising and enter acting with children. Children were under the direct visual supervision of staff.

LPA inspected the building inside and out. The Preschool Room A, children restroom, staff restroom, maintenance/utility storage area, and Offices were inspected.

Outdoor activity space for the Preschool Program is fenced. Play equipment were maintained in a safe condition and free of hazards. Areas around and under high climbing equipment were cushioned with material that absorbs falls. Drinking water is arranged to be readily available for children in care. Shade is provided by trees, building overhang, canopy etc.

There were no bodies of water observed. Director stated that facility does not have weapons on the premises. Furniture and equipment were observed to be age appropriate and in good condition, free of sharp, loose, or pointed parts. Restroom for children to use were observed to be in operating conditions. Floors were clean.
First Aid Kit was inspected. LPA observed facility has fully charged fire extinguishers smoke and carbon monoxide detectors, and fire alarm and sprinkler system. Records show that the last fire/disaster drill was conducted on 08/19/2022 Earthquake Drill Aug 26 2022
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Stephanie Collins
LICENSING EVALUATOR SIGNATURE: DATE: 09/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/29/2022
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
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: SAN JOSE GRAIL FAMILY SERVICES
FACILITY NUMBER: 434414756
VISIT DATE: 09/29/2022
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Facility provides snacks to the AM and PM sessions. Food storage and preparation areas were clean, free of litter, and rubbish. Foods and beverages were kept protected against contamination and spoilage. Menu was posted. Trash cans for solid waste have tight fitting lid.
LPA reviewed sign in and out record and procedure with Director. A sampling of children and staff files was taken for review during today's inspection. Children records reviewed include Admission Agreement, Identification and Emergency Contact Information, Consent for Emergency Medical Treatment form, receipt of Parent Rights Notice, Personal Rights Notice, Medical Assessment, and Immunization.

Staff records reviewed include Criminal Record and Child Abuse Index Clearance, Education Qualification, Health Screening Report with TB Clearance, Immunization (Measles and Pertussis) record and required Training. LPA reminded Director that the online AB1207 Mandated Reported Training needs to be renewed every two years. There was at least one person with current certification in Pediatric CPR and First Aid present at the facility. Director stated facility is not providing transportation to children.

Facility representative Anarita Reyes 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.

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

Exit interview conducted and report was reviewed with the facility representative Anarita Reyes .

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.



In the areas that were evaluated, no regulatory violations were observed at the time of the visit. Exit interview was conducted, where this report, the violations, plan of corrections, and appeal rights were discussed with Director.
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Stephanie Collins
LICENSING EVALUATOR SIGNATURE:

DATE: 09/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/29/2022
LIC809 (FAS) - (06/04)
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