434415356-4-28-2021-07-CC-AMOS-C2HRZC-20210428132742

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434415356
Report Date: 04/28/2021
Date Signed: 04/28/2021 01:27:48 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:	AGAPE CHRISTIAN PRESCHOOL OF SAN JOSE		FACILITY NUMBER:	434415356
ADMINISTRATOR:	LEE, SOOHO		FACILITY TYPE:	850
ADDRESS:	729 MORSE STREET		TELEPHONE:	(408) 472-8288
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95126
CAPACITY:	38	CENSUS: 6	DATE:	04/28/2021
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Soohoo Lee and Jamy Jo		TIME COMPLETED:	01:30 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 Analysts (LPA's) Anna Morales and Stephanie Collins conducted a Case Management via ZOOM with Owner/ Site Director Soohoo Lee and Site Director for Naglee License (434415355), Jamy Jo. They are requesting a toddler option program for a capacity of 10 on the preschool license in classroom Faith 1. Fire clearance was granted on 4/2/2021. This report with LPA's signature will be emailed to the Program Director. In lieu of Program Director's signature, his response to LPA's email will be the confirmation of receipt of this licensing report. During today's inspection, LPA's observed carbon monoxide detectors, fire extinguishers, and fire alarms in each of the classrooms. LPA's observed six children present with two fully qualified teachers in the Hope 3 Classroom The Toddler option room Faith 1 and Toddler Option Outdoor Measurements were measured on *04/12/18 by LPA* *Stephanie Range:* Faith 1 Room: 18.083 x 20.500 = 370.701 minus 2.710 encumbered space = 367.991 Preschool rooms, Love 1: 21.083 x 26.5415+1.998=561.572 Hope 3 classroom: ( *previously measured by LPA Shannel Reed on 10/25/2019) 28.83 x 17.21=410.1143 minus encumbered 13.176-=396.938 Total Indoor Activity Space* : 1377.534 sq ft divided by 35 = 39.358 children (page 1 of 3)

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Anna Morales	TELEPHONE: (408) 334-8325
LICENSING EVALUATOR SIGNATURE:	DATE: 04/28/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2021

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 3

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: AGAPE CHRISTIAN PRESCHOOL OF SAN JOSE	FACILITY NUMBER: 434415356
	VISIT DATE: 04/28/2021

NARRATIVE

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LPA's observed inside the Toddler Option Room ( Faith 1 Class) a bathroom and a sink separate from the preschool classroom. Staff have separate bathrooms. LPA's observed cubbies for each of the children's belongings, a table, chairs and sufficient toys and activities. The children will bring all their food from home which will include snacks for twice a day and lunch, and their own personal water bottle. Water bottles will be provided if needed. LPA's observed the Toddler Component playground which is outside of the classroom. It is separate from the Preschool children.
OUTDOOR MEASUREMENTS ( previously measured by LPA Shannel Reed on 10/25/2019) ARE AS FOLLOWS for TODDLER COMPONENT
PLAYGROUND AREA/ toddler playground 34.167 x 19 = 649.173
TOTAL OUTDOOR SPACE: 649.173 sq. ft. divided by 75 = 8 preschool children.

LPA's observed that the Toddler playground areas are surrounded by appropriate fencing. The playground equipment is age appropriate. There are slides in playground and material that absorbs falls. Shade is provided by a covered patio area. There are adequate equipment, supplies, and toys for children outdoors. LPA's did not observe any bodies of water during today's inspection. Transportation will not be provided by the Facility.

LPA's observed the two Preschool rooms ( Love Class and Hope 3). Hope 3 had three children and two teachers. The Love Classroom did not have any children or teachers present. There are 2 (30) sinks and 2 (30) toilets available to the preschool children. There is no hot water available in the children's sink. Staff have separate bathrooms, located in the building, that can be utilized by sick children if necessary. Sick children will be isolated in the director's office located in preschool center # 434415355 and isolation equipment is provided. LPA's did not observe any fireplaces. The preschool rooms have appropriate lighting & ventilation. First aid supplies were observed inaccessible to the children. There is one staff on site with the full 16 hours of Health and Safety Training. Medications will be stored in the Love classroom inaccessible to children. Children will bring all foods from home which will include snacks for twice a day and lunch. LPA observed solid waste containers with tight-fitting lids. Cleaning supplies will also be stored in the the locked outside janitorial closet inaccessible to children. Drinking water will be provided indoors via personal water bottles There is a working telephone at the site. The phone number is (408) 394-1385.

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SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Anna Morales	TELEPHONE: (408) 334-8325
LICENSING EVALUATOR SIGNATURE:	DATE: 04/28/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2021

LIC809 (FAS) - (06/04)

Page: 2 of 3

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: AGAPE CHRISTIAN PRESCHOOL OF SAN JOSE	FACILITY NUMBER: 434415356
	VISIT DATE: 04/28/2021

NARRATIVE

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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

LPA's informed Directors of the applicable $100 civil penalty per person per day, a minimum of $100.00 to a maximum of $3000.00 per person 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.

Currently the Facility has three waivers on file. One waiver is for shared playground use with Naglee facility,(#434415355) the second waiver on file is to allow co-mingling with the Naglee facility from 3PM- 6PM, and the third waiver on file is a Capacity waiver allowing for the facility to be licensed, even though the facility's playground space only measures for 8 children.

A Toddler Component will be granted upon manager's review and approval pending the following item:

1. Applicant will a request for a Waiver for Outdoor space for the Toddler Option which is to include a schedule so that they don't exceed the capacity of 8.

Covid- Self Assessment submitted and filed

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Anna Morales	TELEPHONE: (408) 334-8325
LICENSING EVALUATOR SIGNATURE:	DATE: 04/28/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2021

LIC809 (FAS) - (06/04)

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