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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 274408752
Report Date: 10/24/2023
Date Signed: 10/26/2023 01:19:27 PM

Document Has Been Signed on 10/26/2023 01:19 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:KIDS AT PLAYFACILITY NUMBER:
274408752
ADMINISTRATOR:DENISE CARATTINIFACILITY TYPE:
850
ADDRESS:1441 CONSTITUTION BLVD. # 151TELEPHONE:
(831) 769-8697
CITY:SALINASSTATE: CAZIP CODE:
93906
CAPACITY: 52TOTAL ENROLLED CHILDREN: 21CENSUS: 13DATE:
10/24/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Indya HawthoneTIME COMPLETED:
02:00 PM
NARRATIVE
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On 10/24/2023 at 9:00am, Licensing Program Analyst (LPA), Farida Raja, met with Designated Teacher (Facility Representative), Indya Hawthone, for an unannounced Required 1-Year inspection in the Preschool Program. LPA explained the nature of today's visit. Teacher stated that Director, Denise Carattini was not at the facility due to a family emergency. The facility is licensed to serve children ages 2 years to entry into first grade in rooms 15 and 16. This facility also has an infant program (#274408753) on site. LPA observed the required posted materials in the hallway leading to the classroom and emergency plan and sketch in each classroom. Days and hours of operation are Monday through Friday, 7:00 am to 6:00 pm.

Upon arrival, LPA observed 13 preschool children with one teacher in one preschool room. Facility is not operating within ratio and capacity requirements of the license. LPA toured the indoor and outdoor areas of the preschool program during today's inspection.

The classrooms, children's restrooms, staff restroom and storage area were inspected. Children were engaged in various activities under the visual supervision of teachers. Facility has central heating/cooling for comfort of children. Teacher states that there are no weapons or firearms on the premises. There is a working telephone at the facility (831-769-8697). Disinfectants and cleaning products were stored in the storage room inaccessible to the children in care. Furniture and equipment were age appropriate and free of sharp, loose, or pointed parts. Floors were clean and free from tripping hazards. LPA observed appropriate changing tables that have raised sides (3 inches in height) and have vinyl changing pads that are at least 1 inch thick. LPA observed napping mats in plastic bags for each individual child. LPA observed solid waste containers with tight-fitting lids in the rooms. Restrooms and sinks for children were observed to be safe, sanitary, and in working condition. LPA observed a trash can with tight fitting cover for the disposal of diapers in each room. Staff has one separate bathroom that can be utilized by sick children if needed.

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SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Farida Raja
LICENSING EVALUATOR SIGNATURE: DATE: 10/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/24/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 7
Document Has Been Signed on 10/26/2023 01:19 PM - It Cannot Be Edited


Created By: Farida Raja On 10/24/2023 at 03:16 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: KIDS AT PLAY
FACILITY NUMBER: 274408752

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/24/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
101216.3(a)
Teacher-Child Ratio
(a) There shall be a ratio of one teacher visually observing and supervising no more than 12 children in attendance, except as specified in (b) and (c) below.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and interview, the licensee did not comply with the section cited above which poses an immediate health, safety or personal rights risk to persons in care. Upon arrival, LPA observed one teacher with 13 preschool children. Teacher/Facility Representative stated that one teacher was on break.
POC Due Date: 10/25/2023
Plan of Correction
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Director will submit Plan of Correction to LPA by 10/25/2023 stating how the facility will remain in ratio at all time.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Gladys Kuizon
LICENSING EVALUATOR NAME:Farida Raja
LICENSING EVALUATOR SIGNATURE:
DATE: 10/24/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/24/2023


LIC809 (FAS) - (06/04)
Page: 2 of 7
Document Has Been Signed on 10/26/2023 01:19 PM - It Cannot Be Edited


Created By: Farida Raja On 10/24/2023 at 03:16 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: KIDS AT PLAY
FACILITY NUMBER: 274408752

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/24/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1597.16(a)(1)
Lead Testing
(1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and interview, the licensee did not comply with the section cited above which poses a potential health, safety or personal rights risk to persons in care. FAcility Representative stated that Water Lead Testing was not completed for this facility.
POC Due Date: 11/07/2023
Plan of Correction
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Director will complete the Water Lead Testing and submit proof of completion to LPA by Plan of Correction date of 11/07/2023.
Type B
Section Cited
CCR
101174(d)
Disaster and Mass Casualty Plan
(d) Disaster drills shall be conducted at least every six months.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review, the licensee did not comply with the section cited above which poses a potential health, safety or personal rights risk to persons in care. Facility Representative was unable to find the fire drill log during today's inspection.
POC Due Date: 11/07/2023
Plan of Correction
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Director will submit proof of fire drill to LPA by plan of correction date of 11/07/2023.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Gladys Kuizon
LICENSING EVALUATOR NAME:Farida Raja
LICENSING EVALUATOR SIGNATURE:
DATE: 10/24/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/24/2023


LIC809 (FAS) - (06/04)
Page: 3 of 7
Document Has Been Signed on 10/26/2023 01:19 PM - It Cannot Be Edited


Created By: Farida Raja On 10/24/2023 at 03:16 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: KIDS AT PLAY
FACILITY NUMBER: 274408752

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/24/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review and interview, the licensee did not comply with the section cited above for one staff which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/07/2023
Plan of Correction
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Director will submit proof of completed Mandated Reporter Training by staff S3 to LPA by 11/07/2023.
Type B
Section Cited
HSC
1596.7995(a)(1)
General Provisions and Definitions
(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review and interview, the licensee did not comply with the section cited above which poses a potential health, safety or personal rights risk to persons in care. LPA did not observe immunization records for MMR, Tdap and Influenza for staff S2 and S3.
POC Due Date: 11/07/2023
Plan of Correction
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Director will submit proof of completed immunizations for staff S2 and S3 by plan of correction date of 11/07/2023.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Gladys Kuizon
LICENSING EVALUATOR NAME:Farida Raja
LICENSING EVALUATOR SIGNATURE:
DATE: 10/24/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/24/2023


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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: KIDS AT PLAY
FACILITY NUMBER: 274408752
VISIT DATE: 10/24/2023
NARRATIVE
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LPA observed fire extinguishers and fire pull stations. The facility has a built-in smoke detector/ fire system. Facility Representative was unable to provide the Fire Drill Log. LPA reminded representative that fire drills need to be conducted and documented every 6 months.

Drinking water is readily available for children indoors and in the outdoor playground area via individual water bottles/sippie cups, drinking fountains and refilled using store bought water gallons.

Childcare Center did not complete water lead testing prior to their deadline. Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP). LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP. LPA referred teacher to the Department website for lead: Lead Toxicity Prevention and Water Testing Information.

Foods and beverages were stored safely to prevent contamination and spoilage. Food storage and preparation areas were observed to be sanitary. Teacher stated that all food is brought from home and the center only provides snacks.

Outdoor playground and play equipment was inspected and observed to be fenced in. LPA toured 3 outdoor play spaces for preschool children. LPA observed that some play equipment like children's car, bikes and play structure was worn and rusted in some places. Play equipment observed was age-appropriate, and has sufficient resilient materials (rubber foam mats) to absorb falls. Shaded rest area is provided by large canopies. There were no bodies of water observed. The playground area utilized by children is surrounded by appropriate fencing.

Children sign in and out procedures and logs were reviewed. Children's roster was reviewed, and a copy was provided to the LPA. LPA reviewed three (3) children's files during today's inspection. Each child's file reviewed contained the required forms.

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SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Farida Raja
LICENSING EVALUATOR SIGNATURE:

DATE: 10/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/24/2023
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: KIDS AT PLAY
FACILITY NUMBER: 274408752
VISIT DATE: 10/24/2023
NARRATIVE
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LPA reviewed three (3) staff files. All staff files reviewed contain the required transcripts/verification of experience. At least one staff member on site has a current CPR and First Aid certification on file. Director understands that there shall be at least one person, with valid CPR and First Aid certifications, on site at all times or present during off-site activities (field trips). LPA did not observe the required Mandated Reporter Training on file for staff, S3. Two staff (S2 and S3) did not have the required Immunization's against Pertussis, Measles an Influenza (or an Opt out statement).

Teacher was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Teacher stated that the Facility does not administer medications at this time and currently has no children in care who require Incidental Medical Services (IMS). Isolation of sick child was discussed, and Teacher explained that sick children will be isolated in a separate area in the classroom away from the other children and isolation equipment will be provided. A staff restroom which is off limits to other children is used if necessary. Child is always under visual supervision while in care of the facility.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

Facility does not provide transportation to children, but staff understand that children cannot be left alone, unattended in parked vehicles.

Facility representative was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

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SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Farida Raja
LICENSING EVALUATOR SIGNATURE:

DATE: 10/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/24/2023
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: KIDS AT PLAY
FACILITY NUMBER: 274408752
VISIT DATE: 10/24/2023
NARRATIVE
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To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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

One (1) Type A and Four (4) deficiencies were cited today on the attached LIC 809D pages. Appeal rights and LIC 9224 were printed and given to Licensee. Due to the issuance of a Type A Citation during today's inspection, a copy of this Licensing Report must be given to each existing parent by the end of today or next day child is in care, and to any newly enrolled parents/guardians enrolled over the next 12 months from the date of this report. In addition, a copy of the LIC 9224 Acknowledgement of Receipt of Licensing Reports must be signed by each parent and kept in each child's file. LPA reminded Licensee that failure to correct deficiencies by Plan of Correction Due Date may result in penalties of $100 per day per violation.

Facility Representative stated that she will have Director submit an updated Emergency Disaster Plan to LPA.
Exit interview conducted and report was reviewed with the Facility Representative, Indya Hawthone and Director, Denise Carattini via phone.

A NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 DAYS.
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Farida Raja
LICENSING EVALUATOR SIGNATURE:

DATE: 10/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/24/2023
LIC809 (FAS) - (06/04)
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