430702131-7-24-2024-07-CC-FRAA-D7H25J-20240724170534

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 430702131
Report Date: 07/24/2024
Date Signed: 07/24/2024 05:05:52 PM

Document Has Been Signed on 07/24/2024 05:05 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:	EAST VALLEY CHRISTIAN PRESCHOOL		FACILITY NUMBER:	430702131
ADMINISTRATOR:	CHRISTINE BELTRAN		FACILITY TYPE:	850
ADDRESS:	2715 SOUTH WHITE ROAD		TELEPHONE:	(408) 270-2560
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95148
CAPACITY:	144	CENSUS: 73	DATE:	07/24/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	08:46 AM
MET WITH:	Eddie Perez and Dora Cortez		TIME COMPLETED:	02:40 PM

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On 07/24/2024 at 8:46am, Licensing Program Analyst (LPA), Farida Raja, met with East Valley Christian School Principal, Eddie Perez and Staff, Dora Cortez for an unannounced annual/random inspection. The facility is licensed to serve children ages 2-6 years in four rooms. The facility has one waiver on file for shared outside playground space between East Valley Christian School and East Valley Christian Preschool. LPA observed the required posted materials in the office area and menus and daily activity schedule in each classroom. Days and hours of operation are Monday through Friday, 6:30 am to 6:00 pm.

LPA and Principal toured the indoor and outdoor areas during today's inspection and observed the following ratios:

Room K-111: Not in use at this time

Room K-112 (2-3 years): 19 children and 3 teachers

Room K-113 (3-4 years): 23 children and 2 teachers

Room K-114 (4-5 years): 29 children and 3 teachers

Present during the beginning of the inspection were 71 preschool children and 8 staff. Classrooms, children's restrooms, staff restrooms, food preparation area and office area were inspected. Children were engaged in circle time indoors and free play outdoors under the visual supervision of teachers. Facility has central heating/cooling for comfort of children. Staff states that there are no weapons or firearms on the premises. There is a working telephone at the facility (408-270-2560). Disinfectants and cleaning products were stored inaccessible to the children in care in high cabinets. Furniture and equipment were age appropriate and in good condition, free of sharp, loose, or pointed parts. LPA observed solid waste containers with tight-fitting lids in the rooms. LPA observed appropriate changing table that has raised sides (3 inches in height) and have vinyl changing pad that is at least 1 inch thick in Room K112.

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SUPERVISOR'S NAME: Gladys Kuizon	TELEPHONE: (510) 566-5850
LICENSING EVALUATOR NAME: Farida Raja	TELEPHONE: (916) 926-9269
LICENSING EVALUATOR SIGNATURE:	DATE: 07/24/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/24/2024

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-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: EAST VALLEY CHRISTIAN PRESCHOOL	FACILITY NUMBER: 430702131
	VISIT DATE: 07/24/2024

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LPA observed a trash can with tight fitting cover for the disposal of diapers. Napping equipment is appropriate. Restrooms and sinks for children were observed to be safe, sanitary, and in working condition. Staff has one separate bathroom that can be utilized by sick children if needed.

LPA observed fire extinguishers, working smoke and carbon monoxide detectors. Log shows that the last Fire Drill was conducted on 05/11/2024 which is compliant with the six-month requirement for facilities.

Drinking water is readily available for children in each room and in the outdoor playground area via individual water bottles or store bought water bottles. Facility has a written attestation on file which states that no water outlets/ water fountains at the facility are used for drinking or food preparation purposes. During interview with Staff, Staff stated that sink in food preparation area is used for washing fruits and vegetables (food preparation). LPA reminded Staff that if they use the sink for food preparation including washing fruits and vegetables then the facility must follow the testing guidance outlined in the written directives, and test outlets prior to initial use of tap water for drinking water or food preparation.

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 referred Staff to the Department website for lead: Lead Toxicity Prevention and Water Testing Information.

Principal stated that lunch is brought from home and the facility provides AM and PM snack. Menu was observed to be posted. Food and beverages were stored safely to prevent contamination and spoilage. Food storage and preparation areas were observed to be sanitary.

LPA observed outdoor areas, Playground A and B. The outdoor activity area is fenced. The playground equipment is maintained in safe condition, free of sharp, loose or pointed parts. Areas around play structures were cushioned with resilient materials to absorbs falls. Principal stated that Playground B is not in use at this time. Shaded rest areas are provided through trees and sheet metal awnings. LPA did not observe any bodies of water. There is adequate equipment, supplies, and toys for children outdoors.

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SUPERVISOR'S NAME: Gladys Kuizon	TELEPHONE: (510) 566-5850
LICENSING EVALUATOR NAME: Farida Raja	TELEPHONE: (916) 926-9269
LICENSING EVALUATOR SIGNATURE:	DATE: 07/24/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/24/2024

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-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: EAST VALLEY CHRISTIAN PRESCHOOL	FACILITY NUMBER: 430702131
	VISIT DATE: 07/24/2024

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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 9 children’s files during today's inspection. Each child's file reviewed contained the required forms. Child C2 and C3 are missing the physician's report (LIC 701).

Five staff files were reviewed. Staff S1 and S2 do not have valid fingerprint clearances. Based on interview, with Principal and Staff, S1 and S2 have obtained fingerprint clearances as they work at East Valley Christian School but fingerprints have not been transferred to East Valley Christian Preschool. A review of staff records indicates that staff S1 to S5 are missing several required documents. LPA provided Staff, Dora with a list of missing documentation to be provided as a plan of correction. At least one staff member on site has a current CPR and First Aid certification. Staff 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). Staff S2-S4 are missing proof of all immunization's, S1 is missing proof of Tdap and influenza and S5 is missing proof of influenza/statement declining the vaccine.

Principal and Staff 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.

Incidental Medical Services (IMS) policy was discussed. Principal and Staff stated that there are no children that require medications or IMS at this time. 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. Any medications at the Facility are stored in a lock box in the office area/classroom and are inaccessible to children in care. Facility has an IMS plan on file. Isolation of sick child was discussed, and Director explained that sick children will be isolated in the director's office 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. 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/.

LPA also provided the e-mail address for the advocates in order to be added to the quarterly newsletter mailing list. childcareadvocatesprogram@dss.ca.gov. Child Care Advocate Program: https://cdss.ca.gov/inforesources/child-care-licensing/child-care-advocates

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SUPERVISOR'S NAME: Gladys Kuizon	TELEPHONE: (510) 566-5850
LICENSING EVALUATOR NAME: Farida Raja	TELEPHONE: (916) 926-9269
LICENSING EVALUATOR SIGNATURE:	DATE: 07/24/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/24/2024

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-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: EAST VALLEY CHRISTIAN PRESCHOOL	FACILITY NUMBER: 430702131
	VISIT DATE: 07/24/2024

NARRATIVE

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

Staff 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.

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

In areas that were evaluated, Type A and Type B violations were observed and were cited on the attached LIC 809D pages. Appeal rights and LIC 9224 were printed and provided 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 to confirm receipt of licensing report. LPA reminded Licensee that failure to correct deficiencies by Plan of Correction Due Date may result in civil penalties.

Exit Interview was conducted, where this report, the citations, plan of corrections, and appeal rights were reviewed and discussed with Staff, Dora Cortez.

NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 DAYS.

SUPERVISOR'S NAME: Gladys Kuizon	TELEPHONE: (510) 566-5850
LICENSING EVALUATOR NAME: Farida Raja	TELEPHONE: (916) 926-9269
LICENSING EVALUATOR SIGNATURE:	DATE: 07/24/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/24/2024

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 07/24/2024 05:05 PM - It Cannot Be Edited

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: EAST VALLEY CHRISTIAN PRESCHOOL	FACILITY NUMBER: 430702131
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/24/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101170(e)(2)

101170 Criminal Record Clearance (e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility: (2) Request a transfer of a criminal record clearance as specified in Section 101170(f). This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, interview and staff roster review, two staff, S1 and S2 have obtained fingerprint clearances as they work at East Velley Christian School but fingerprints for both staff have not been transferred to East Valley Christian Preschool. Therefore the licensee did not comply with the section cited which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 08/07/2024
	Plan of Correction
1 2 3 4	Director/Staff will submit a written plan of correction to LPA by Plan of correction date of 08/07/2024.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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	TELEPHONE: (510) 566-5850
LICENSING EVALUATOR NAME: Farida Raja	TELEPHONE: (916) 926-9269
LICENSING EVALUATOR SIGNATURE:	DATE: 07/24/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/24/2024

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 07/24/2024 05:05 PM - It Cannot Be Edited

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: EAST VALLEY CHRISTIAN PRESCHOOL	FACILITY NUMBER: 430702131
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/24/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type A

Section Cited

CCR

101216.1(c)(1)

Teacher Qualifications and Duties

(c) To be a fully qualified teacher, a teacher shall have one of the following: (1) Twelve postsecondary semester or equivalent quarter units in early childhood education or child development completed, with passing grades, at an accredited or approved college or university; and at least six months of work experience in a licensed child care center or comparable group child care program. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, interview and record review, the licensee did not comply with the section cited above for staff, S1 which poses an immediate health, safety or personal rights risk to persons in care. Based on interview staff, S1 is not a fully qualified teacher and was observed in a classroom with 23 children and one fully qualified staff.
	POC Due Date: 07/25/2024
	Plan of Correction
1 2 3 4	Director/Staff to submit a plan of correction to LPA by POC due date of 07/25/2024.

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
1 2 3 4	Based on observation, interview and record review, the licensee did not comply with the section cited above which poses an immediate health, safety or personal rights risk to persons in care. Based on interview staff, S1 is not a fully qualified teacher and was observed in a classroom with 23 children and one fully qualified staff therefore placing the classroom out of ratio.
	POC Due Date: 07/24/2024
	Plan of Correction
1 2 3 4	Director/Staff to submit a plan of correction to LPA by POC due date of 07/25/2024.

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	TELEPHONE: (510) 566-5850
LICENSING EVALUATOR NAME: Farida Raja	TELEPHONE: (916) 926-9269
LICENSING EVALUATOR SIGNATURE:	DATE: 07/24/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/24/2024

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 07/24/2024 05:05 PM - It Cannot Be Edited

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: EAST VALLEY CHRISTIAN PRESCHOOL	FACILITY NUMBER: 430702131
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/24/2024

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
1 2 3 4	Based on 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. During interview with Staff, Staff stated that sink in food preparation area is used for washing fruits and vegetables (food preparation). LPA reminded Staff that if they use the sink for food preparation including washing fruits and vegetables then the facility must follow the testing guidance outlined in the written directives, and test outlets prior to initial use of tap water for drinking water or food preparation. LPA informed Staff to either have outlet tested or to use bottled water for washing fruits and vegetables.
	POC Due Date: 08/07/2024
	Plan of Correction
1 2 3 4	Director/Staff to submit a plan of correction to LPA by POC due date of 08/07/2024.

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
1 2 3 4	Based on observation, interview and record review, the licensee did not comply with the section cited above for 5 staff, S1-S5 which poses/posed a potential health, safety or personal rights risk to persons in care. Staff S2-S4 are missing proof of all immunization's, S1 is missing proof of Tdap and influenza and S5 is missing proof of influenza/statement declining the vaccine.
	POC Due Date: 08/07/2024
	Plan of Correction
1 2 3 4	Director/Staff to submit a plan of correction to LPA by POC due date of 08/07/2024.

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	TELEPHONE: (510) 566-5850
LICENSING EVALUATOR NAME: Farida Raja	TELEPHONE: (916) 926-9269
LICENSING EVALUATOR SIGNATURE:	DATE: 07/24/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/24/2024

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 07/24/2024 05:05 PM - It Cannot Be Edited

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: EAST VALLEY CHRISTIAN PRESCHOOL	FACILITY NUMBER: 430702131
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/24/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101220(a)

Child's Medical Assessments

(a) Prior to, or within 30 calendar days following the enrollment of a child, the licensee shall obtain a written medical assessment of the child. This medical assessment enables the licensee to assess whether the center can provide necessary health-related services to the child. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, interview and record review, the licensee did not comply with the section cited above for two children, C2 and C3 which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 08/07/2024
	Plan of Correction
1 2 3 4	Director/Staff to submit a plan of correction to LPA by POC due date of 08/07/2024.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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	TELEPHONE: (510) 566-5850
LICENSING EVALUATOR NAME: Farida Raja	TELEPHONE: (916) 926-9269
LICENSING EVALUATOR SIGNATURE:	DATE: 07/24/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/24/2024

LIC809 (FAS) - (06/04)

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