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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 430701361
Report Date: 12/03/2024
Date Signed: 12/03/2024 11:59:37 AM

Document Has Been Signed on 12/03/2024 11:59 AM - 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 CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:ACTION DAY NURSERYFACILITY NUMBER:
430701361
ADMINISTRATOR/
DIRECTOR:		SMRTI DATTAFACILITY TYPE:
850
ADDRESS:2146 LINCOLN AVENUETELEPHONE:
(408) 266-8952
CITY:SAN JOSESTATE: CAZIP CODE:
95125
CAPACITY: 154TOTAL ENROLLED CHILDREN: 154CENSUS: 110DATE:
12/03/2024
TYPE OF VISIT:Case Management - Annual ContinuationUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:52 AM
MET WITH:Smriti DattaTIME VISIT/
INSPECTION COMPLETED:
12:15 PM
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Licensing Program Analyst (LPA), Jennifer “Jen” Beehler, met with Director, Smriti Datta, for an unannounced Required- Annual Inspection Continuation from Tuesday 11/26/2024. Upon arrival, LPA was granted access to the facility by the Director Datta and provided staff files for review. There were 110 children (preschool age) and 18 staff present, which is compliant with the facility license capacity and ratio requirements. LPA observed all required postings near the entrance to the facility. Hours of operation for the facility are Monday – Friday, 07:00AM-06:00PM.

LPA reviewed facility roster (LIC9040), and fire/disaster drill log during today’s inspection. The Sign-in/out document was not able to be printed from the electronic records. A waiver is active for children sign in/out records to be kept digitally. LPA discussed this with the Director and she will work with her corporate office to create a report that will be accessible to licensing for review. The last fire/disaster drill was conducted on 10/16/2024, which is compliant with the six month requirement for facilities. LPA observed a fully charged 2A10BC fire extinguisher that was last serviced 12/14/2023 which is compliant with fire marshal requirements. LPA reminded Director to schedule the service call so fire extinguishers are serviced every year. LPA observed functioning smoke detector and carbon monoxide detector. Director states that she does currently have children in care who require Incidental Medical Services. Director stated the medication was locked in the office in the original packaging with the doctor's directives stored with the medication and a separate copy in a binder in the event a quick exit with children is required.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and
administrative records.
For IMS information see PIN 22-02-CCP. 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/.

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SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Jennifer Beehler
LICENSING EVALUATOR SIGNATURE: DATE: 12/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/03/2024
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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: ACTION DAY NURSERY
FACILITY NUMBER: 430701361
VISIT DATE: 12/03/2024
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The Director states that there are no weapons or firearms on the premises.

Indoor areas of the facility were inspected by the LPA today and observed to be clean, orderly, and safe for the day care children. LPA observed sufficient age-appropriate materials, toys, and play equipment in the facility. Furniture, such as tables, chairs, and shelves, are in good condition and safe for children. The floors were clean and free of tripping hazards. Drinking water is readily available for children in the facility via Brita water filter and dispensers. The children bring water bottles from home labeled with the their names. Staff and children’s bathrooms are clean, sanitary, and operable. There is a separate staff bathroom, not utilized by the children. The Facility has a working telephone. Cleaning and maintenance for the facility is conducted by an outside service and is completed in the evenings after all day care children have left the premises each night Monday through Friday. Director advised if children become ill, they will be isolated in the main office until parents can come pick them up.

LPA discussed the safe sleep regulations with the Director and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed Director of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

The outdoor area of the facility was inspected and observed to be fenced in. LPA observed play equipment was in good condition, age-appropriate, and has sufficient resilient materials (wood bark) to absorb falls. LPA observed the steps to one of the play structures in the back play area to be torn. This could be a trip hazard for children in care. Director disclosed that a maintenance ticket had been placed to correct the problem. No outdoor bodies of water were observed during today’s inspection. Shaded rest area is provided by canopies.

A morning and afternoon snack is provided by the facility and is stored, prepared, and served in a safe and healthful manner to the children. Menu is in writing and posted at least one week in advance, accessible to authorized representatives.

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SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Jennifer Beehler
LICENSING EVALUATOR SIGNATURE:

DATE: 12/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2024
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 CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: ACTION DAY NURSERY
FACILITY NUMBER: 430701361
VISIT DATE: 12/03/2024
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The kitchen and storage area is clean and free of litter and rubbish. Equipment necessary for the storage, preparation and service of food is well maintained, clean, and sanitized after each use. LPA observed stored food and refrigerated food not expired during inspection.

10 children’s files (preschoolers) were reviewed for the following records: Physician’s Report (LIC701), Notification of Parents Rights (LIC995A), Consent for Emergency Medical Treatment (LIC627), Identification and Emergency Information (LIC700), Acknowledgment of Receipt of Licensing Report (LIC9224) dated 04/12/2024 & 04/18/2024, Signed Admission Agreement, and Immunization Records (PM286). LPA observed all files to be complete.

6 staff files (teachers) were reviewed for the following records: Transcripts/Verification of Experience, Health Screening Report (LIC503), Employee Rights (LIC9052), Criminal Record Statement (LIC508), Statement Acknowledging Requirement to report Child Abuse (LIC9108), Mandated Reporter Training Certificate, Tuberculosis (TB) Clearance, and Immunization Record showing immunity to measles (MMR), pertussis (Tdap), and influenza (or statement declining influenza). There is at least one staff member present with current CPR/First-Aid that expires 05/18/2026. LPA reminded the Director that the Mandated Reporter Training must be renewed by all staff every 2 years. LPA observed 4/6 (four out of six) staff members did not have the criminal record statement (LIC508) included in the file. LPA reminded Director to insure that all files were complete at all times.

The Director understands that the site director shall be on the premises during the hours the center is in operation and that children at the center shall be visually supervised at all times. LPA reminded the Director 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, such as field trips.

Due to today's inspection, no deficiency was cited. Exit interview conducted with the Director, Smriti Datta, report reviewed and provided along with appeal rights.

NOTICE OF SITE VISIT PROVIDED AND MUST REMAIN POSTED FOR 30 DAYS.
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Jennifer Beehler
LICENSING EVALUATOR SIGNATURE:

DATE: 12/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2024
LIC809 (FAS) - (06/04)
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