434415557-9-5-2019-07-CC-JTSE-BFQQ7U-20190905115544

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434415557
Report Date: 09/05/2019
Date Signed: 09/05/2019 11:55:51 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:	FOOTHILL HEAD START		FACILITY NUMBER:	434415557
ADMINISTRATOR:	RENEE GARCIA		FACILITY TYPE:	850
ADDRESS:	2750 RIVERRUN DRIVE		TELEPHONE:	(408) 392-3891
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95127
CAPACITY:	48	CENSUS: 0	DATE:	09/05/2019
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Renee Garcia & Pedro Sousa		TIME COMPLETED:	12:15 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	LPAs Janet Tse and Susy Cervantes met with Renee Garcia, Supervisor of Preschool Sites, and Pedro Sousa, Site Director, for a pre-licensing visit. The preschool is applying for a capacity of 48 children at this facility. LPAs toured the facility both inside and out as well as measured the indoor and outdoor space. The following indoor measurements were taken today: ROOM 2 (Foothill 2) 34.500 x 27.917 = 963.136 minus 123.545 (encumbered space) = 839.591 ROOM 3 (Foothill 3) 32 x 27.917 = 893.344 minus 49.321 (encumbered space) = 844.023 *TOTAL PRESCHOOL INDOOR SPACE: 1,683.614 sq. ft. divided by 35 = 48 children.* There are 4 toilets (60) and 6 sinks (90) available for the children. Only cold water is available in the children's sinks. There is 1 separate staff bathroom which is located in the staff room and will be used by the sick child as well as an outdoor bathroom. The sick child will be isolated in the Director's office and isolation equipment is provided. LPAs observed no fireplaces or wall heaters at the facility. Air conditioning is provided in both rooms. The rooms have appropriate lighting. The center will be administering medication and medication lock box is located in the upper cabinet above sink counter. First aid supplies are stored in each room, are adequate and are inaccessible to children. Cleaning supplies are stored in a locked janitor's closet. The center will be providing breakfast, lunch, and snacks for the children from a third party vendor that will be delivered the day before pre-made and pre-packed. The food will be reheated in the kitchen in the staff room which is equipped with refrigerator, microwave, stove, dishwasher, and sink with hot and cold running water. Disposable utensils, dishes, and cups will be utilized for the children. LPAs observed solid waste container with tight-fitting lid in the classrooms, playground, and kitchen. There are 40 cubbies (20 of which can be shared and have enough shelving/division for 40 children), 10 tables of different sizes, 61 chairs, 40 cots (some children in the inclusive program do not take naps). Children will be coming to the center on a full-time basis. Drinking water is available indoor by water canister. Facility Evaluation Report dated 09/05/2019 to be continued on next page:

SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Janet Tse	TELEPHONE: (408) 334-8547
LICENSING EVALUATOR SIGNATURE:	DATE: 09/04/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/05/2019

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: FOOTHILL HEAD START	FACILITY NUMBER: 434415557
	VISIT DATE: 09/05/2019

NARRATIVE

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Facility Evaluation Report dated 09/05/2019 to be continued from previous page:

Outdoor measurements and information are:
PRESCHOOL PLAYGROUND
79 x 49.083 = 3,877.557
65.417 x 47.833 = 3,129.091
Playground total = 7,006.648 minus 590.75 (encumbered space) = 6,415.898
TOTAL PRESCHOOL OUTDOOR SPACE: 6,415.898 sq. ft. divided by 75 = 85 children.

The playground is surrounded by appropriate fencing. Playground will be shared with the Santa Clara County Office of Education Special Education Program. A waiver has been submitted during today's visit to share the playground. Drinking water is provided through a water fountain and also water jugs. LPAs observed no bodies of water. No transportation is provided by the school. Shade is provided through large trees and building overhang.

Clearances for individuals at this facility who require caregiver background checks are issued by the State Dept. of Education and/or County Office of Education and do not come under the jurisdiction of Community Care Licensing division.

This facility plans to provide Incidental Medical Services – IMS. For IMS information, see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. A 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. IMS plan is already in Head Start administrative file.

The director has completed the 16 hours of health and safety training. A fire clearance for 48 preschool children (2.9 years old to 5 years old) was received on August 27, 2019 from the San Jose Fire Department.

An exit interview was conducted prior to the conclusion of today's visit and LPA advised Pedro Sousa and Rene Garcia that a license for 48 children will be approved pending on Licensing Management approval.

SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Janet Tse	TELEPHONE: (408) 334-8547
LICENSING EVALUATOR SIGNATURE:	DATE: 09/05/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/05/2019

LIC809 (FAS) - (06/04)

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