434416169-11-20-2019-07-CC-YHUG-BJ4QVZ-20191120113111

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434416169
Report Date: 11/20/2019
Date Signed: 11/20/2019 11:31:16 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:	GRAIL FAMILY SERVICES LEARNING ACADEMY/SAN JOSE GR		FACILITY NUMBER:	434416169
ADMINISTRATOR:	N/A - TBD		FACILITY TYPE:	850
ADDRESS:	14845 STORY ROAD		TELEPHONE:	(408) 347-7892
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95127
CAPACITY:	24	CENSUS: 0	DATE:	11/20/2019
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Nereyda Hurtado		TIME COMPLETED:	12:00 PM

NARRATIVE

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Licensing Program Analyst (LPA), Oscar Huang, met with Applicant Representative/Director, Nereyda Hurtado, for a preschool prelicensing inspection. Applicant is applying for 24 preschool children in between 3 to 5 years old with potty trained. The facility will be offering two half-day programs per day, Monday thru Friday from 8:00 AM to 11:30 AM & 12:30 PM to 4:00 PM. LPA toured the facility inside and out as well as measured the space available for the children. Measurements are as follows:

INDOOR MEASUREMENTS:

Classroom 1: 18.333 x 12.250 - 6 = 218.579

Classroom 2: 11.250 x 12.667 + 6.5 x 3.5 - 2 x 3 = 159.235
Classroom 3: 19.5 x 17.583 - 12 = 330.868
Kitchen/Eating room: 14.333 x 9.667 - 2 x 13 - 2.25 x 2.333 = 133.307

TOTAL INDOOR SPACE FOR PRESCHOOL = 841.989 sq. ft. divided by 35 sq. ft. = 24 children.

There are 2 toilets (30) and 3 sinks (45) available for the preschool children. LPA observed dispenser soap and disposable paper towels in the bathrooms. Staff have a separate bathroom located next to Office room that can be utilized by sick children if necessary. Sick children will be isolated in the Office Room and isolation equipment is provided.

LPA observed a blocked fireplace in classroom 1. All rooms have appropriate lighting and ventilation (central heating and air conditioning). First aid supplies are stored in each room placed on the top shelf of the cabinet inaccessible to children. The facility provides snacks, fruit and vegetable. Since the facility only operates half-day programs, no lunches & naps will be provided. There is a microwave, and a refrigerator in kitchen/eating room. There is two sinks in children bathroom and one sink in classroom 3 with hot and cold running water. Cleaning supplies are stored in the locked cabinets under the sink of the kitchen inaccessible to the children. Each classroom has trash can with tight fitting cover for the disposal of solid waste.

REPORT CONTINUED ON THE FOLLOWING PAGE (PAGE #2 - DATED 11/20/2019):

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Yangcheng Huang	TELEPHONE: 408-334-8321
LICENSING EVALUATOR SIGNATURE:	DATE: 11/20/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/20/2019

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: GRAIL FAMILY SERVICES LEARNING ACADEMY/SAN JOSE GR	FACILITY NUMBER: 434416169
	VISIT DATE: 11/20/2019

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REPORT CONTINUED ON THE FOLLOWING PAGE (PAGE #1 - DATED 11/20/2019):
The center will not administer medication. LPA advised applicant When any IMS is provided in the future, a Plan of operation for Providing IMS must be submitted to the Department. LPA observed total of 29 chairs, 24 cubbies, 6 tables at site. Drinking water indoor is via water dispenser with disposal cups. A phone for communication is in the office. Applicant stated that there are no weapons on the premises. LPA also observed one combined carbon monoxide and smoke detector in each room, and two 3A-40-BC fire extinguishers installed in the facility.

A review of staff records on today indicates that applicant/director is associated with the facility with require caregiver background checks have received criminal record and child abuse index clearances.

OUTDOOR MEASUREMENTS:

Playground: 19.25 x 18 + 88 x 25 + 7.5 x 36.833 + 18 x 19 = 3,164.747

TOTAL OUTDOOR SPACE FOR PRESCHOOL 3,164.747 sq. ft. divided by 75 sq. ft. = 42 preschool children.

LPA observed that the preschool playground is surrounded by appropriate fencing. The playground equipment is age appropriate. Wood barks are used as resilient materials around and under the play structure. Shade is provided by trees & building overhang. Drinking water will be provided outdoor via water pitcher and disposal cups. LPA did not observe any bodies of water during today's visit. Transportation will not be provided by the facility.

LPA discussed Senate Bill 792, Assembly Bill (AB) 1207 (Mandated Child Abuse Reporting Training) which is required training that began on January 1, 2018 and requires renewal every two years, AB 633 was discussed with Supervisor. Licensing forms, Title 22 regulations, can be obtained through the internet at www.ccld.ca.gov. Mandated Reported Training can be accessed at http://www.mandatedreporterca.com/. Applicant completed her mandated reporter training and her certification is on file. For all new hire employees, the training will be completed before they start.

Assembly Bills regarding Lead Exposure was discussed with and provider information 19-04-CCP was provided to applicant.

A fire safety inspection approval was received from the San Jose Fire Department on 11/05/2019. Rooms approved are Classrooms 1, 2, 3, office, kitchen, eating & cubby area.

LPA conducted an exit interview with applicant/director and advised her that the Child Care Center preschool license for 24 Preschool children is now pending upon Management Approval.

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Yangcheng Huang	TELEPHONE: 408-334-8321
LICENSING EVALUATOR SIGNATURE:	DATE: 11/20/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/20/2019

LIC809 (FAS) - (06/04)

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