434415853-1-14-2025-07-CC-FRAA-DCX2VM-20250114164408

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434415853
Report Date: 01/14/2025
Date Signed: 01/14/2025 04:44:19 PM

Document Has Been Signed on 01/14/2025 04:44 PM - 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:	ALOHA MONTESSORI		FACILITY NUMBER:	434415853
ADMINISTRATOR/ DIRECTOR:	MARGARET EYERMAN		FACILITY TYPE:	850
ADDRESS:	995 APRICOT AVENUE		TELEPHONE:	(408) 858-9886
CITY:	CAMPBELL	STATE: CA	ZIP CODE:	95008
CAPACITY: 28	TOTAL ENROLLED CHILDREN: 6	CENSUS: 5	DATE:	01/14/2025
TYPE OF VISIT:	Case Management - Other	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	01:28 PM
MET WITH:	Magdalena Kraintz		TIME VISIT/ INSPECTION COMPLETED:	03:45 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	On 01/14/2025 at 1:28pm, Licensing Program Analysts (LPAs), Farida Raja and Jaimie Gonzales conducted an unannounced case management inspection. LPAs met with Staff, Magdalene (Maggie) Kraintz and explained the purpose of today's visit. Staff stated that Director is not at the facility. LPAs observed an updated Designation of Facility Responsibility (LIC 308) on file. During staff interview, staff stated that Director is present at the facility once a week and not all hours the facility is in operation. Qualified staff was observed to be present during today's inspection. During today's inspection, LPAs observed 5 children and 2 staff. Facility is operating within ratio requirements. LPAs conducted a facility walk through of the indoor and outdoor areas with Staff. LPA's reviewed 5 children's files for the Acknowledgement of Receipt of Licensing Reports (LIC 9224) for the Type A deficiency cited on 05/06/2024. All children were observed to have a signed LIC 9224 on file. LPAs observed a Incidental Medical Plan on file for one child. LPAs advised Staff to submit a plan of operation to administer incidental medical services to LPA by 01/28/2025. During facility walk through, LPAs observed the sandbox in the outdoor area has a lot of debris and is not covered when not in use. LPAs observed the side outdoor area has discarded pipes, gardening tools, broken children's table, paint dispenser cans, raid fly trap sticks and hose storage cans filled with water and debris in the area on limit to children in care. LPAs reminded Staff that sandboxes should be covered to prevent hazardous foreign materials and debris from entering. Facility must be maintained in good repair and items hazardous to children should made inaccessible or placed out of reach of children. LPAs observed that the areas under swings had the dirt showing and advised Staff to replenish the tan bark. LPAs observed a door leading to an off limit area from the children's bathroom is not made inaccessible to children. LPAs advised staff to place a child lock on the door so the area beyond cannot be accessed by children in care. Two Type B deficiencies and one technical violation were cited as a result of today's inspection. Appeal rights provided. Exit interview conducted and report was reviewed with Staff, Magdalene (Maggie) Kraintz . A NOTICE OF SITE VISIT WAS ISSUED AND MUST REMAIN POSTED FOR 30 DAYS.

Gladys Kuizon	TELEPHONE: (510) 566-5850
Farida Raja	TELEPHONE: (916) 926-9269
	DATE: 01/14/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/14/2025

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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Document Has Been Signed on 01/14/2025 04:44 PM - It Cannot Be Edited

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: ALOHA MONTESSORI	FACILITY NUMBER: 434415853
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/14/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Section Cited

Outdoor Activity Space (f) Sandboxes shall be inspected daily and kept free of hazardous foreign materials. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4
	POC Due Date: 01/28/2025
	Plan of Correction
1 2 3 4	Director to cover sandbox when not in use to prevent any hazardous foreign materials and debris from entering the sandbox. Director shall submit a photo showing the sandbox covered to Community Care Licensing (CCL) by the POC date of 01/28/2025.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

Gladys Kuizon	TELEPHONE: (510) 566-5850
Farida Raja	TELEPHONE: (916) 926-9269
	DATE: 01/14/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/14/2025

LIC809 (FAS) - (06/04)

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