434416233-11-14-2019-07-CC-YHUG-BHWRUK-20191114122004

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434416233
Report Date: 11/14/2019
Date Signed: 11/14/2019 12:20:09 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:	CENTENARY ACADEMY		FACILITY NUMBER:	434416233
ADMINISTRATOR:	ELDA NAIPING LIU		FACILITY TYPE:	850
ADDRESS:	383 SPAR AVENUE		TELEPHONE:	(408) 636-8966
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95117
CAPACITY:	35	CENSUS: 0	DATE:	11/14/2019
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	08:40 AM
MET WITH:	Elda Liu		TIME COMPLETED:	12:35 PM

NARRATIVE

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Licensing Program Analyst (LPA), Oscar Huang, met with Applicant/Director, Elda Liu, for a preschool prelicensing inspection . Applicant is applying for 35 preschool children. Days and hours of operation will be Monday thru Friday from 7:30 AM to 6:00 PM. LPA toured the facility inside and out as well as measured the space available for the children. Measurements are as follows:

INDOOR MEASUREMENTS:

Room 1: 23 x 19.75 - 66.39 = 387.86

Room 2: 16.833 x 16 - 4.5 = 264.828
Room 3: 14.083 x 16 - 4.5 = 220.828
Room 4: 10.5 x 12.5 - 3.167 = 128.083
Room 5: 26.75 x 15.25 + 8.25 x 5.667 - 6.666 = 448.024

TOTAL INDOOR SPACE FOR PRESCHOOL = 1,449.623 sq. ft. divided by 35 sq. ft. = 41 children.

There are 3 toilets (45) and 3 sinks (45) available for the preschool children. Both hot & cold water is available for sinks. LPA observed dispenser soap and disposable paper towels in the bathrooms. Staff have a separate bathroom located in the hallway across the 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, there is no wall heaters at the facility. All rooms have appropriate lighting and ventilation (central heating and air conditioning). First aid supplies are stored in office room, kitchen, and children bathroom on the top shelf inaccessible to children. The facility provides snacks, fruit and vegetable. Children will be brought their own lunches. There is a microwave, a dishwasher, a range stove, an oven, and a refrigerator in the kitchen. Cleaning supplies are stored in the garage inaccessible to the children. Each classroom has trash can with tight fitting cover for the disposal of solid waste. The center will provide IMS service. The IMS Plan of Operation was submitted to the department and on file.

REPORT CONTINUED ON THE FOLLOWING PAGE (PAGE #2 - DATED 11/14/2019):

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Yangcheng Huang	TELEPHONE: 408-334-8321
LICENSING EVALUATOR SIGNATURE:	DATE: 11/14/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/14/2019

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: CENTENARY ACADEMY	FACILITY NUMBER: 434416233
	VISIT DATE: 11/14/2019

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REPORT CONTINUED ON THE FOLLOWING PAGE (PAGE #1 - DATED 11/14/2019):
LPA observed total of 42 chairs, 42 cubbies, 11 tables, and 35 mats at site. Drinking water indoor is via filled water dispenser, and children's own water bottles. A phone for communication is in the each of the classroom. Applicant stated that there are no weapons on the premises. LPA also observed two carbon monoxide detectors and five smoke detectors, and two 3A-40-BC fire extinguishers.
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: 75.25 x 52 + 18 x 25 - 2 x 8 = 4,347

TOTAL OUTDOOR SPACE FOR PRESCHOOL and TODDLER: 4,347 sq. ft. divided by 75 sq. ft. = 57 preschool children.

LPA observed that the preschool playground is surrounded by appropriate fencing. The playground equipment is age appropriate. Rubber mats & grasses are used as resilient materials around and under the play structure. Shade is provided by covered patio & tree. Drinking water will be provided outdoor via water pitcher with children's own water bottles. 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 applicant. 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 his mandated reporter training on 03/07/2018 and his certification is on file. For all new hire employees, the training will be completed before they start.

Applicant/Director is applying an exception for her director position to complete the Preventive Health & Safety by the end of February as her current certification was completed on 07/15/2012 which does not include an hour of nutrition.

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

A fire safety inspection approval was received from the San Jose Fire Department on 10/28/2019. Rooms approved are Rooms 1 to 5, Bathrooms 1 & 2, and outdoor backyard area. Off Limits Areas: Office, Staff Bathroom 3, Kitchen and Garage.

LPA conducted an exit interview with applicant and advised her that her Child Care Center preschool license for 35 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: 11/14/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/14/2019

LIC809 (FAS) - (06/04)

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