434416230-1-15-2020-07-CC-SCOS-BKV2LU-20200115163006

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434416230
Report Date: 01/15/2020
Date Signed: 01/15/2020 04:30:15 PM

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:	SJB-FOOTHILL CHILD DEVELOPMENT CENTER		FACILITY NUMBER:	434416230
ADMINISTRATOR:	REBECCA LARSEN		FACILITY TYPE:	830
ADDRESS:	230 PALA AVENUE		TELEPHONE:	(408) 928-5223
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95127
CAPACITY:	9	CENSUS: 0	DATE:	01/15/2020
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Kelly Mercurio, Rebecca Larsen, & Melissa Leza		TIME COMPLETED:	11:30 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 Analysts (LPAs), Stephanie Collins and Tuoc Doan met with Executive Director Kelly Mercurio and Site Director Rebecca Larsen, and Program Director Melissa Leza. Applicant SJB Child Development Centers is applying for a license to operate an Infant Center at the address listed above. The requested capacity is 11 infant ages 0 to 18 months. During the inspection, Applicant's Representative requested to add a Toddler Component to the Infant Center. A Fire Clearance was granted on 01/09/2020 by SJFD. The Child Care Center is located on a functioning school site: Foothill High School. LPAs inspected the indoor and outdoor, on limit and off limit areas, as well as measured the space available for the children. Indoor measurements are as follows: Infant Class Room = (Total sq. ft.) – (Total Encumbered Space) = (328.34 sq. ft.) – (11.76 sq. ft.) = 316.58 sq. ft. *Total Infant Indoor Activity Space =* *(316.58 sq. ft.) divided by (35 sq. ft. / child) = 9 Infants* Toddler Class Room = (Total sq. ft.) – (Total Encumbered Space) = (637.956 sq. ft.) – (27.84 sq. ft.) = 610.116 sq. ft. Total Toddler Indoor Activity Space = (610.116 sq. ft.) divided by (35 sq. ft. / child) = 17 Toddlers** There is one toilet and two sinks for the toddler program children to use.

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Stephanie Collins	TELEPHONE: (408) 334-8555
LICENSING EVALUATOR SIGNATURE:	DATE: 01/15/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2020

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: SJB-FOOTHILL CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 434416230
	VISIT DATE: 01/15/2020

NARRATIVE

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Infant Yard:
= (Total sq. ft.) – (Total Encumbered Space) = (2,028 sq. ft.) – (0 sq. ft.)
= 2,028 sq. ft.

Total Infant Outdoor Activity Space = (2,028 sq. ft.) divided by (75 sq. ft. / child) = 27 Infants

LPAs observed that the Infant yard is enclosed by fencing. Infants and Toddler will us the Infant Yard at alternating schedule to ensure that infants and toddlers are not commingled. Grass serves as resilient materials in the yard. Shade is provided by trees. LPA did not observe any bodies of water during the visit. Site Director stated that facility will not provide transportation.

LPAs also observed age appropriate toys, furniture, and equipment in the Infant room. There were feeding chairs, cushioned floor mats for activities, and cubbies. Sleeping area is physically separated from the indoor activity space. There were 6 cribs observed in the napping area. Facility also have cots for the older infants who are able to climb out of cribs. The Infant Center will not be providing potty training. The infant room has one changing table within arm's reach of one sink. The changing table raised sides that are at least 3 inches high, and have padded surface that is no less than one-inch thick. Site Director understands that a baby walker shall not be used at a child day care facility. Drinking water is readily available indoor and outdoor.

There is one staff restroom in common area. The Director’s office will be used to isolate an infant who becomes ill and should be equipped with a mat or a crib for ill infant if needed and the infant will be supervised by staff during isolation. There were no fireplaces or open space heaters observed. The Infant room has heating, lighting, and ventilation for the safety and comfort of infant in care. First aid supplies were observed. Medications will be stored in a locked box in the classroom and in the Director's Office.

Facility will follow each infant’s Feeding Plan. Feeding chairs and other appropriate seating equipment will be used to seat infants during feeding. Infants shall be held during feedings if they are unable to sit unassisted. Propped bottles are not permitted. Facility provides Lunch, and Morning and Afternoon snacks. Menu is posted. Meals will be provided by the corporation’s centralized meal service facility. Meals and snacks will be delivered to the center, stored, refrigerated, and heated as needed at the on-site Kitchen until served to the children. The kitchen is equipped with stoves, ovens, hot and cold running water, refrigerator, and dishwasher. LPA observed trash cans with tight fitting covers for the disposal of solid waste.

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Stephanie Collins	TELEPHONE: (408) 334-8555
LICENSING EVALUATOR SIGNATURE:	DATE: 01/15/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2020

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: SJB-FOOTHILL CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 434416230
	VISIT DATE: 01/15/2020

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There are two sinks in the Kitchen with hot/cold running water. Areas designated for storage of detergents, cleaning compounds, sharps, medicines, and other items which could pose a danger if readily available to children are inaccessible to infants.

Site Director Rebecca Larsen meets Director’s Educational Qualification requirement. There is at least one staff with current certification for preventive health practices training, which included current pediatric cardiopulmonary resuscitation and pediatric first aid certification. Director maintains documentation of immunity against Measles and Pertussis and required training. Site Director and Executive Director Background Check Clearance have been transferred to the Infant Center.

LPAs reminded Site Director of the applicable civil penalties for those adults who have not received fingerprint clearances, are not associated to the license, and who come in contact with or provide care and supervision to the children. For an initial violation, civil penalty amounts to $100.00 per person up to $500.00 per person. For a subsequent violation within a 12-month period, civil penalty amounts to $100.00 per person up to $3000.00 per person.

This facility plans to provide Incidental Medical Services – IMS and had submitted a Plan of Operation that includes IMS. 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.

Exit interview was conducted, where this report was reviewed with Site Director Rebecca Larsen and Program Director Melissa Leza.

Applicant's Representatives were informed that the following pending items need to be submitted:
1) Updated LIC200A
2) Updated Facility sketch to accurately reflect the layout and use of the rooms.
3) Infant and Toddler Outdoor Activity schedule

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Stephanie Collins	TELEPHONE: (408) 334-8555
LICENSING EVALUATOR SIGNATURE:	DATE: 01/15/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2020

LIC809 (FAS) - (06/04)

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