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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434415214
Report Date: 11/16/2022
Date Signed: 11/16/2022 03:30:37 PM


Document Has Been Signed on 11/16/2022 03:30 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:SJB - FRANKLIN CDCFACILITY NUMBER:
434415214
ADMINISTRATOR:SINDY PULIDOFACILITY TYPE:
850
ADDRESS:420 TULLY ROADTELEPHONE:
(408) 414-2700
CITY:SAN JOSESTATE: CAZIP CODE:
95111
CAPACITY:44CENSUS: 32DATE:
11/16/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:47 AM
MET WITH:Arenas, AnahiTIME COMPLETED:
04:00 PM
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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 44. Licensing staff met with Director Arenas, Anahi and explained the nature of today’s inspection. This is a preschool program that currently operates from 7:00 AM to 6:00 PM, Monday thru Friday. Every second Tuesday of each program month closes at 1:30 PM. This facility is on Franklin Elementary School Campus.

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 32 children in care with one Director and 7 fully qualified teachers.

Physical Plant: All areas identified on the Facility Sketch were inspected. This is a preschool program, which consists of the following classrooms: Preschool Classroom, LPA observed the following: Staff # 1 Director, teachers (Staff #2 thru 4) and 15 preschool children. Children in this classroom are 3 to 4 years old. Teacher child ratios were observed, and staff names recorded. Personal rights observed. There is access to two classroom sinks, two lavatory sinks (four in total) and two toilets.

Pre-K Calssroom: LPA observed the following: Staff # 5 thru 8 with 17 children. The children in this classroom are 4 to 5 years old. Teacher child ratios were observed, and staff names recorded. Personal rights observed. There is access to two classroom sinks, two lavatory sinks (four in total) and two toilets.

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. 1/7
SUPERVISOR'S NAME: Diana StephensonTELEPHONE: (408) 324-2128
LICENSING EVALUATOR NAME: Araceli AlmarazTELEPHONE: (408) 324-2148
LICENSING EVALUATOR SIGNATURE:
DATE: 11/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/16/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 7


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: SJB - FRANKLIN CDC
FACILITY NUMBER: 434415214
VISIT DATE: 11/16/2022
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General sanitization & safety: Each child has their own cubby to store their belongings. Per Director, sick children are isolated in the director's office. 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, per Director garbage bins with foot petals to open were recently ordered. Garbage bins expected to arrive this week. General sanitation was observed.

Availability of indoor drinking water was observed in classrooms, through filtered pitchers. Disinfectants, cleaning solutions, medication and other hazardous items that pose a risk to children, were inaccessible to the children in care, out of reach and locked. 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 monthly, in classroom, on parent board and given copies upon request. Menus for the past one year are available upon request. Facility provides breakfast, lunch and PM snack. LPA reviewed food for availability, quantity, and appropriateness to children in care. Per Director, all meals are prepared daily at the main center, San Juan Baustista # 430703695 and transported to facility. Snacks and supplemental food with 5 components kept on site. LPA observed an allergy list for each child posted in kitchen area. LPA and director discussed a name, picture and allergy list to be posted in kitchen area for best practice. Director states this is in process. Per Director there are 3 children enrolled with allergies, all mild.

Lavatories: There are two lavatories adjacent, with two sinks and two toilets in each room. A total of four lavatory sinks and four toilets in the facility. 2/7

SUPERVISOR'S NAME: Diana StephensonTELEPHONE: (408) 324-2128
LICENSING EVALUATOR NAME: Araceli AlmarazTELEPHONE: (408) 324-2148
LICENSING EVALUATOR SIGNATURE:

DATE: 11/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/16/2022
LIC809 (FAS) - (06/04)
Page: 2 of 7
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: SJB - FRANKLIN CDC
FACILITY NUMBER: 434415214
VISIT DATE: 11/16/2022
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All toilets and hand washing facilities are in safe and sanitary operating conditions. All materials and surfaces accessible to children are toxic free. At this time, there are 44 children enrolled. LPA and Director discussed when at full capacity, a child will use the staff lavatory. Director states there is always a floater for such situations, in order to keep teacher-child ratio.

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. All areas around or under high climbing equipment, swings, slides, and similar equipment are cushioned with material that absorbs a fall. There is adequate shade in the play yard. Availability of outdoor drinking water was observed. This playground is not shared with the elementary school. There is a portable sandbox, covered with a lid when not in use and inspected daily or as needed. The playground is fully fenced. LPA observed one locked storage shed and four locked boxes, all containing toys. There is an area that is fenced offed off. Per Director this is currently off limits, it will be renovated and used in the future. LPA and Director discussed crevices in the pavement and play turf surfacing. There are two facets that are capped off with water supply cut off. There is access to one outdoor sink.

Facility Records: LPA/s issued Review of Staff records (LIC 859) to the Director during this inspection. At least one staff (Director) has record of CPR and First Aid, valid until 10/18/2024. All staff present have the following: MMR & Tdap vaccinations, flu vaccine or the opt out. All staff has completed Mandated Reporter Training, Director’s training valid thru 09/07/2023. Directors understand this must be renewed every two years. LPA/s reviewed 2 children's files and issued an LIC 857. LPA reviewed 8 staff files total. All files were observed to be complete.

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

Waivers: There are no waivers on file. 3/7
SUPERVISOR'S NAME: Diana StephensonTELEPHONE: (408) 324-2128
LICENSING EVALUATOR NAME: Araceli AlmarazTELEPHONE: (408) 324-2148
LICENSING EVALUATOR SIGNATURE:

DATE: 11/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/16/2022
LIC809 (FAS) - (06/04)
Page: 3 of 7
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: SJB - FRANKLIN CDC
FACILITY NUMBER: 434415214
VISIT DATE: 11/16/2022
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Facility Records: LPA/s issued Review of Staff records (LIC 859) to the Director during this inspection. At least one staff (Director) has record of CPR and First Aid, valid until 11/2024. All staff present have the following: MMR & Tdap vaccinations, flu vaccine or the opt out. All staff has completed Mandated Reporter Training, Director’s training valid thru 09/07/2023. Directors understand this must be renewed every two years. LPA/s reviewed 2 children's files and issued an LIC 857. LPA reviewed 8 staff files total. All files were observed to be complete.

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

Waivers: There are waivers on file.

Medical & First Aid Supplies: There is a first aid kit in each classroom, kept in backpacks near the exit. There are extra first aid kits in cabinets. LPA reviewed kit to ensure supplies are complete. Director states that supplies are checked every week or month, depending on needs. Per Director medication is only administered to a child when accompanied with a doctor's note, parent plan, authorizations are to be completed monthly. The medication is kept in a locked cabinet or in a locked box in refrigerator if needed and/or in emergency backpack when outside (at least six feet high) which is stored out of reach of children.



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 4/7
SUPERVISOR'S NAME: Diana StephensonTELEPHONE: (408) 324-2128
LICENSING EVALUATOR NAME: Araceli AlmarazTELEPHONE: (408) 324-2148
LICENSING EVALUATOR SIGNATURE:

DATE: 11/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/16/2022
LIC809 (FAS) - (06/04)
Page: 4 of 7
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: SJB - FRANKLIN CDC
FACILITY NUMBER: 434415214
VISIT DATE: 11/16/2022
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Fire & Safety: Carbon monoxide detectors and smoke detectors are working and present in the facility, per Director the fire department conducted a fire inspection on 10/11/2022. There is a Fire extinguisher, size 3A40BC in each room, last serviced 03/30/2022. Last fire drill was conducted on 10/20/2022, Director understands this is to be completed at least every six months.

Matts and cots: Cots inspected for napping were observed to be maintained in a safe condition with no exposed foam. Constructed of material at least 3/4 inch thick. Covered with vinyl or similar material that can be wiped. Designed so that the sleeping side can be distinguished from the floor side. Per Director cots are wiped daily with a detergent, disinfectant or when soiled or wet. Each cot observed to be equipped with a sheet and/or blanket to cover the child. Per Director bedding is not shared and is washed on site each Thursday (or when soiled) to be laundered. LPA reminded Director that bedding shall be individually stored so that each child's bedding is identifiable, and no child's used bedding shall meet other bedding. Bedding is stored on top of each cot, so as not to touch.



Lead Testing: Director states lead testing has been done. There was no lead detected. LPA obtained a copy of the report. LPA and Director discussed the LIC 9275, a completed signed and dated childcare sampling checklist form LIC9276 and a facility sketch LIC 999 fully labeled with locations of all water outlets to their LPA and self-report testing results.

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 updated LIC 610 during visit. LPA obtained a copy for licensing file. 5/7

SUPERVISOR'S NAME: Diana StephensonTELEPHONE: (408) 324-2128
LICENSING EVALUATOR NAME: Araceli AlmarazTELEPHONE: (408) 324-2148
LICENSING EVALUATOR SIGNATURE:

DATE: 11/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/16/2022
LIC809 (FAS) - (06/04)
Page: 5 of 7
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: SJB - FRANKLIN CDC
FACILITY NUMBER: 434415214
VISIT DATE: 11/16/2022
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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/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 child care 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.

LPA advised the facility representative to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov. 6/7
SUPERVISOR'S NAME: Diana StephensonTELEPHONE: (408) 324-2128
LICENSING EVALUATOR NAME: Araceli AlmarazTELEPHONE: (408) 324-2148
LICENSING EVALUATOR SIGNATURE:

DATE: 11/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/16/2022
LIC809 (FAS) - (06/04)
Page: 7 of 7
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: SJB - FRANKLIN CDC
FACILITY NUMBER: 434415214
VISIT DATE: 11/16/2022
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There are no deficiencies being cited in accordance with Title 22 of the California Code of Regulations and Health & Safety codes.

LPA and Director discussed the following: 1. A name to face list of allergies posted. 2. Updated LIC 610, relocation sites, which has been updated. 3. Fill in crevices and holes in play turf surfacing. 4. Director packet was submitted to LPA during visit, LPA will review and update 5. LIC 9275, a completed signed and dated childcare sampling checklist form LIC9276 and a facility sketch LIC 999 fully labeled with locations of all water outlets to their LPA and self-report testing results, to be submitted to licensing office. Director understands that while facility is currently in compliance, failure to take such measures may result in future citations. LPA may conduct an unannounced case management if needed to inspect the facility for updates.

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. 7/
SUPERVISOR'S NAME: Diana StephensonTELEPHONE: (408) 324-2128
LICENSING EVALUATOR NAME: Araceli AlmarazTELEPHONE: (408) 324-2148
LICENSING EVALUATOR SIGNATURE:

DATE: 11/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/16/2022
LIC809 (FAS) - (06/04)
Page: 6 of 7