434415408-7-14-2023-07-CC-MSMS-CTQNYC-20230714105230

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434415408
Report Date: 07/14/2023
Date Signed: 07/14/2023 10:52:34 AM

Document Has Been Signed on 07/14/2023 10:52 AM - 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:	HILLSIDE CHRISTIAN PRESCHOOL		FACILITY NUMBER:	434415408
ADMINISTRATOR:	MARLENE ALLEN		FACILITY TYPE:	850
ADDRESS:	545 HILLSDALE AVENUE		TELEPHONE:	(408) 269-1995
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95136
CAPACITY:	45	CENSUS: 0	DATE:	07/14/2023
TYPE OF VISIT:	Case Management - Licensee Initiated	ANNOUNCED	TIME BEGAN:	08:40 AM
MET WITH:	Marlene Allen		TIME COMPLETED:	11:15 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	Licensing Program Analyst (LPA) Mel Matos met with Marlene Allen, director, for an announced case management inspection. Purpose of today's case management inspection: The Facility is requesting to add Room 210 to the license and increase the licensed capacity from 45 to 60 preschool children. The Facility is currently licensed to serve children ages 2 to 6 years in Rooms 205, 207, & 209. Hours of operation: 8:30 AM to 2:30 PM. Marlene states that the Facility is currently closed for summer break. LPA toured the indoor/outdoor areas of the Facility during today's inspection. Director states that indoor & outdoor layout of the Facility has not changed since the Facility was licensed and thus no measurements were taken during today's inspection. INDOOR MEASUREMENTS: Room 210: 43.333 x 23.167 = 1,003.895 Room 209:13.417 x 2.667 + 18.667 x 19.417 + 17.250 x 13.167 = 592.173 minus 23.294 (encumbered space) = 568.879 Room 207:18.583 x 36.417 = 676.737 minus 20.453 (encumbered space) = 656.284 Room 205:18.583 x 36.417 = 676.737 minus 17.391(encumbered space) = 659.346 TOTAL INDOOR PRESCHOOL SPACE: 2,888.404 SQ. FT. DIVIDED BY 35 = 82 CHILDREN. The bathroom for the preschool children are located down the hall from Room 205 and have signs on the doors indicating that the preschool has exclusive use of the bathrooms during the preschool operating hours. The children are escorted and supervised by staff members at all times when using the bathrooms. There are 3 toilets (45), 1 urinal (15), and 4 sinks (60) available for the children in the two bathrooms. There are six sinks available in the classrooms. Hot (less than 120 degrees F) and cold water is available in the children's sinks. Sick children will be isolated away from other children in the Director's office and will use the staff bathroom.

SUPERVISOR'S NAME: Diana Stephenson	TELEPHONE: (408) 324-2158
LICENSING EVALUATOR NAME: Melvin S Matos	TELEPHONE: (408) 334-8554
LICENSING EVALUATOR SIGNATURE:	DATE: 05/25/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/14/2023

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: HILLSIDE CHRISTIAN PRESCHOOL	FACILITY NUMBER: 434415408
	VISIT DATE: 07/14/2023

NARRATIVE

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There are adequate chairs, tables, cubbies, napping mats, equipment, supplies, and toys for the children within the Facility. Director understands that walkers and items of similar nature are not permitted. Director understands that the children must be under direct visual supervision at all times. Drinking water will be provided by reusable water bottles, water pitchers, and disposable cups both indoors and outdoors.
OUTDOOR MEASUREMENTS -

Playground with play structure for 2 - 5 year olds 54.833 x 27.083 = 1,485.042
Playground with play structure for 3 - 11 year olds 52.250 x 6.750 + 29.167 x 26.417 + 34.583 x 25 = 1,987.767
TOTAL PRESCHOOL OUTDOOR SPACE: 3,472.809 sq ft divided by 75 = 46 children.

Marlene understands that the 3-11 year old play structure is not age appropriate for children younger than 3 years old per the manufacturers recommendations and will not have children use the play structure that are less than 3 years old.

LPA observed that the preschool playground is surrounded by appropriate fencing, The preschool playground adequately fenced. Shade is provided via sun sails & trees. The playground equipment is age appropriate and wood chips are used as resilient materials. There are adequate equipment, supplies, and toys for children outdoors.

LPA received a fire clearance approval from the San Jose Fire Department prior to today's inspection.

No deficiencies issued during today's inspection.

Exit interview conducted and report was reviewed with Marlene Allen, Director, and advised her that a preschool license for 60 preschool children will be approved upon completion of the following.

1) Waiver request for the outdoor playground space has been submitted and approved.

Notice of site visit issued and must remain posted for 30 days.

SUPERVISOR'S NAME: Diana Stephenson	TELEPHONE: (408) 324-2158
LICENSING EVALUATOR NAME: Melvin S Matos	TELEPHONE: (408) 334-8554
LICENSING EVALUATOR SIGNATURE:	DATE: 07/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/14/2023

LIC809 (FAS) - (06/04)

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