434415215-10-3-2019-07-CC-AALZ-BGLQ9C-20191003115807

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434415215
Report Date: 10/03/2019
Date Signed: 10/03/2019 11:58:16 AM

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:	LIDIA'S PRESCHOOL AND DAY CARE CENTER		FACILITY NUMBER:	434415215
ADMINISTRATOR:	ATKINS, MARIA		FACILITY TYPE:	850
ADDRESS:	637 CALERO AVENUE		TELEPHONE:	(669) 234-7886
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95123
CAPACITY:	18	CENSUS: 3	DATE:	10/03/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	08:36 AM
MET WITH:	Atkins, Maria		TIME COMPLETED:	11:57 AM

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	An unannounced Annual Random Inspection was conducted in Spanish, on this day by Licensing Program Analyst (LPA) Almaraz, Araceli. Facility is currently licensed for a capacity of 18. Licensing staff met with Director Atkins, Maria. The program currently operates 7 AM to 6 PM, Monday thru Friday. Licensing staff was taken on a guided tour walk through of the facility. This is a preschool program which consists of three classrooms; Room 1 thru 3. The preschool currently only utilizes Room 1. LPA notes that Rooms 2 & 3 are not approved for use at this time per the fire clearance. The playground, located adjacent to Room 1 is the only playground area which will be utilized at this time. Director Atkins understands licensing needs to be notified in the case that there are any changes to the rooms and/or playground area being utilized. All areas identified on the Facility Sketch were inspected. Upon arrival, the following staff were present during this inspection: Room 1: Director Atkins with three preschoolers. The total census was three preschoolers in todays visit and one Director/teacher. LPA Almaraz inspected the inside areas of the facility. LPA Almaraz inspected Room 1 and observed furniture and equipment is age appropriate and in sufficient condition. Telephone service, heating, lighting and ventilation were evaluated and meet licensing standards. Storage for children's belongings was observed as compliant. Mat/cots were inspected and sanitary, plastic is used to separate each one. Blanket are brought children's home. Availability of drinking water was reviewed. Toys observed to be sanitary and age appropriate. LPA observed age appropriate sinks and toilets and were inspected for availability, water temperature, toilet paper, area safety and sanitation. There are a total of 2 toilets and 2 sinks available for the preschool children. Director Atkins states potty training is provided by the Facility. LPA Almaraz observed the children's sinks are in working condition and meet licensing standards. LPA Almaraz observed soap dispenser and disposable towels in the preschool bathrooms. Staff has one separate bathroom that can be utilized by sick children if necessary. Sick children are isolated in the director's office. REPORT CONTINUED ON THE FOLLOWING PAGE (PAGE #2 - REPORT DATED 10/03/2019

SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Araceli Almaraz	TELEPHONE: (408) 334-8551
LICENSING EVALUATOR SIGNATURE:	DATE: 10/03/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2019

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: LIDIA'S PRESCHOOL AND DAY CARE CENTER	FACILITY NUMBER: 434415215
	VISIT DATE: 10/03/2019

NARRATIVE

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LPA Almaraz informed Director Atkins to log onto web site www.ccld.ca.gov to obtain forms and LIVE SCAN application. Records for all children and staff must be maintained for three (3) years after separation from the facility.

Director Atkins was also advised of the requirement to report Unusual Incidents and/or injuries to the parent/guardian and to CCL within the time frame specified by the regulation. Director advised to visit www.shotsforschool.org for immunization information.

Director Atkins advised that indoor and outdoor supervision required at all times. If outdoor area not adequately fenced, provider must be with children at all times when outdoors.

These forms may also be downloaded from our website: www.ccld.ca.gov

Exit interview as given and a copy of this report.

THERE ARE NO DEFICIENCIES DURING TODAY'S INSPECTION IN ACCORDANCE WITH CALIFORNIA CODE OF REGULATIONS TITLE 22, DIVISION 12 CHAPTER 1

NOTICE OF SITE VISIT WAS ISSUED AND MUST BE POSTED FOR 30 CONSECUTIVE DAYS.

REPORT CONTINUED FROM THE PAGE (PAGE #4 - REPORT DATED 10/03/2019

SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Araceli Almaraz	TELEPHONE: (408) 334-8551
LICENSING EVALUATOR SIGNATURE:	DATE: 10/03/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2019

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: LIDIA'S PRESCHOOL AND DAY CARE CENTER	FACILITY NUMBER: 434415215
	VISIT DATE: 10/03/2019

NARRATIVE

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LPA Almaraz observed a first aid kit is kept in Room one and in children's bathroom. LPA observed functioning Carbon monoxide and smoke detectors in the facility. LPA Almaraz observed at least one 3A40BC fire extinguisher, last serviced on 10/02/2019. Hazardous items including poisonous cleaning compounds were stored inaccessible to children. All trash receptacles have tight fitting covers. LPA observed required postings including but not limited to; the facility sketch, emergency disaster plan (LIC 610), notification of parent's rights (PUB 393), and the emergency evacuation route map, cubbies for children's personal belongings. At the time of the inspection, LPA observed at least 2 size appropriate tables and 20 chairs available for use. Director Atkins states there are no weapons on the premises.

Snack/lunch menus were reviewed. Food and snacks were reviewed for availability, quantity and appropriateness to children in care. Lunch is brought from home. There a microwave in an adjacent room.

LPA observed all outdoor activity areas. LPA Almaraz observed that the preschool playground is surrounded by appropriate fencing. Shade is provided by trees and a canopy. Drinking water is provided by pitchers of water and disposable cups outdoors. There are adequate equipment, supplies, and toys for children outdoors. Play area was inspected for hazards and inaccessibility to bodies of water; no bodies of water or hazards observed. Transportation will not be provided by the Facility. Outdoor equipment was inspected for safety, cushioning material, sufficient repair and appropriateness. LPA advised that the children need to be within the direct care and supervision, including visual supervision of the teacher(s) at all times.

LPA Almaraz observed facility was in compliance with the following: Teacher child ratios, staff names recorded. Care and supervision was evaluated to determine if the basic needs of children are met and appropriate. Sign-in and out sheets and procedures were reviewed. Personal Rights of children were observed by LPA.

LPA Almaraz reviewed three children's files and observed current and updated immunization records, Admission agreements and Notification of Parents' Rights forms (LIC 995A) in each file. LPA Almaraz observed that the Director Atkins has record of MMR & Tdap vaccinations as well as for the flu vaccine. LPA Almaraz observed a current roster, a current fire disaster/earthquake drills last log 07/19/2019. Director Atkins has day care insurance. Director Atkins has the required units and all other qualifications currently required.
REPORT CONTINUED ON THE FOLLOWING PAGE (PAGE #3 - REPORT DATED 10/03/2019

SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Araceli Almaraz	TELEPHONE: (408) 334-8551
LICENSING EVALUATOR SIGNATURE:	DATE: 10/03/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2019

LIC809 (FAS) - (06/04)

Page: 2 of 4

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: LIDIA'S PRESCHOOL AND DAY CARE CENTER	FACILITY NUMBER: 434415215
	VISIT DATE: 10/03/2019

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Director Atkins completed Mandated Reporter Training on 11/22/2017 and understands training is to be completed every two years. Criminal Record Clearances were reviewed for adult/s. CPR card expires on 11/20/2020.

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

The following was discussed with Director Atkins:
Rooms that are off-limits need to be made inaccessible during operating hours. Smoking is prohibited. No infant walkers or any other item that falls into that category are allowed in facility. The Director was advised that inaccessibility of hazards must be constantly reassessed depending on the children in care including Safe Sleep Awareness. The fire extinguisher type 3A40BC must be serviced annually or as often as necessary. Smoke and Carbon Monoxide detectors should be checked and batteries replaced as needed. Changes should be reported to the Department as soon as they occur such as construction, remodeling, telephone number changes and/or if you move from your location.

Mandatory Forms for the children’s files and staff files, requirements for fire drills, earthquake drills and documentation were discussed. Role and responsibilities of being a Mandated Reporter were reviewed. Director Atkins was advised how to access forms and Regulations online at www.ccld.ca.gov. Director Atkins was made aware that it is his/her responsibility to know the regulations as well as anyone who assists in providing care. The Director was advised that inaccessibility of hazards must be constantly reassessed depending on the children in care.

LPA Almaraz advised Director Atkins that all adults 18 years of age and older providing Care and Supervision and/or have continuous presence in the facility shall adhere to a criminal background clearance with the Department of Justice, FBI and Child Abuse Index Check.
REPORT CONTINUED ON THE FOLLOWING PAGE (PAGE #4 - REPORT DATED 10/03/2019

SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Araceli Almaraz	TELEPHONE: (408) 334-8551
LICENSING EVALUATOR SIGNATURE:	DATE: 10/03/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2019

LIC809 (FAS) - (06/04)

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