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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434415775
Report Date: 03/22/2023
Date Signed: 03/23/2023 08:12:08 AM


Document Has Been Signed on 03/23/2023 08:12 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
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131



FACILITY NAME:SUNFLOWERS MONTESSORI PRESCHOOLFACILITY NUMBER:
434415775
ADMINISTRATOR:CHIA THAOFACILITY TYPE:
850
ADDRESS:667 NORTH FIRST STREETTELEPHONE:
(408) 885-0202
CITY:SAN JOSESTATE: CAZIP CODE:
95112
CAPACITY:46CENSUS: 13DATE:
03/22/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Chia ThaoTIME COMPLETED:
03:00 PM
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Licensing Program Analyst (LPA ) Anna Morales conducted an ANNUAL REQUIRED visit and was greeted by Director Chia Thao. Hours of operation are: 7:30-6:00pm, Monday to Friday and licensed to serve ages 2 years to entry to First grade. LPA observed the required posted materials, including the Facility License, Emergency Disaster Plan (LIC 610), Earthquake Preparedness Checklist (LIC 9148), Parents' Rights Poster (PUB 393), Personal Rights (LIC 613A). Disaster Drill was conducted on March 13, 2023.

LPA observed 13 students and three teachers. Facility was observed to be in compliance with teacher to child ratio requirement during visit.

LPA observed Carbon monoxide and smoke detectors and charged Fire extinguishers. Director stated that facility does not have weapons on the premises. Furniture and equipment were observed to be age appropriate and in good condition, free of sharp, loose, or pointed parts. Disinfectants, cleaning solutions, and other items that are dangerous to children were stored inaccessible Floors were clean. There are cubbies for the children to place their belongings. Observed the sign in and sign out procedure.

Outdoor activity space is enclosed by fencing and is observed to be free of hazards. LPA observed play equipment were in good condition. Observed resilient materials under the climbing structures. The children bring their own water bottles, and the school will offer more if needed. Activities schedule were posted. Facility provides meals and two snacks. LPA observed that food storage areas were clean and free of litter.
SUPERVISOR'S NAME: Gladys KuizonTELEPHONE: (510) 566-5850
LICENSING EVALUATOR NAME: Anna MoralesTELEPHONE: (408) 334-8325
LICENSING EVALUATOR SIGNATURE:
DATE: 03/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/22/2023
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
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: SUNFLOWERS MONTESSORI PRESCHOOL
FACILITY NUMBER: 434415775
VISIT DATE: 03/22/2023
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This facility is providing Incidental Medical Services – IMS Plan. Director stated that she is not providing any IMS services at this time. LPA reviewed supporting documentation of the Children's Centrally Stored Medications. For IMS information see Evaluator Manual- Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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 (TYY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/chidlqanda.htm

LPA reviewed a random selection of children files. Children records reviewed include Admission Agreement, Identification and Emergency Contact, Consent for Emergency Medical Treatment form, receipt of Parent Rights Notice, Personal Rights Notice, Medical Assessment, Immunization.

LPA reviewed Staff's records include Criminal Record and Child Abuse Index Clearance, Health Screening Report and TB test, Immunization (Measles, Pertussis, and Flu) record and required Training. Staff have current Mandated Reporter Training. LPA reminded Director that the online AB1207 Mandated Reported Training needs to be renewed every two years. There was at least one person with current certification in Pediatric CPR and First Aid present at the facility.

LPA also 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.

LPA discussed the requirements of AB 633 and understands the AB 633 fact sheet/copy of Acknowledgement of Receipt of Licensing Reports (LIC 9224). LPA discussed "zero tolerance" related regulations and advised that the assessment of an immediate $500 per day civil penalty for any violation of a "zero tolerance" related regulation. An ongoing civil penalty of $100 per day continues until the violation(s) is corrected.

SUPERVISOR'S NAME: Gladys KuizonTELEPHONE: (510) 566-5850
LICENSING EVALUATOR NAME: Anna MoralesTELEPHONE: (408) 334-8325
LICENSING EVALUATOR SIGNATURE:

DATE: 03/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2023
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
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: SUNFLOWERS MONTESSORI PRESCHOOL
FACILITY NUMBER: 434415775
VISIT DATE: 03/22/2023
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Exit interview conducted and report was reviewed with the Director Chia Thao

No deficiencies cited at today's visit.


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
SUPERVISOR'S NAME: Gladys KuizonTELEPHONE: (510) 566-5850
LICENSING EVALUATOR NAME: Anna MoralesTELEPHONE: (408) 334-8325
LICENSING EVALUATOR SIGNATURE:

DATE: 03/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2023
LIC809 (FAS) - (06/04)
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