430703788-5-4-2023-07-CC-AMOS-CRHSMQ-20230504140019

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 430703788
Report Date: 05/03/2023
Date Signed: 05/04/2023 02:00:40 PM

Document Has Been Signed on 05/04/2023 02:00 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:	BRIARWOOD CHILDREN'S CENTER/STATE PRESCHOOL		FACILITY NUMBER:	430703788
ADMINISTRATOR:	STEPHANIE MASCIOCCHI		FACILITY TYPE:	850
ADDRESS:	1940 TOWNSEND AVE.,RMS25,26&27		TELEPHONE:	(408) 423-1321
CITY:	SANTA CLARA	STATE: CA	ZIP CODE:	95051
CAPACITY: 88	TOTAL ENROLLED CHILDREN: 88	CENSUS: 23	DATE:	05/03/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:45 AM
MET WITH:	Mimi Munoz/Whitney Lukanc		TIME COMPLETED:	02:00 PM

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 Analyst (LPA) Anna Morales conducted an ANNUAL REQUIRED inspection and was greeted by Site Director Jemima"Mimi" Munoz and Whitney Lukanc. In each of the classrooms, LPA observed the required posted materials, including the Facility License, Emergency Disaster Plan (LIC 610), Earthquake Preparedness Checklist (LIC 9148), Parents' Rights Poster (PUB 393), Personal Rights (LIC 613A), Child Car Seat Law (PUB 269), Menus and Activity Schedule. Last disaster drill was conducted on 4/28/2023. Facility's operating days and hours are Monday to Friday 7:30 AM to 5:30 PM in Rooms 25 and 26 (Summer schedule). Room 27 is used by the Briarwood State Preschool children only during school year August - first week of June. The room is not in use during the summer. In Classroom 25: Observed 15 students, with Two teachers and one teachers associate In Classroom 26: Observed 8 students, with Two teachers and one teacher's associate In Classroom 27 (State Preschool): Observed 11 students ( inclusion program), one teacher and one para educator. A Fully charged, 5MB6H Fire extinguishers were observed in the front of the classrooms. The Carbon monoxide detectors are interconnected with the smoke alarms located on the ceilings. Each of the classrooms have refrigerators and cubbies for personal storage. Disinfectants and toxics materials are stored inaccessible to the children. Observed trash bins with tight fitted lids. Each of the classrooms have first aid kits LPA was informed that the parents use a electronic sign in and sign out. The isolation room is one of the offices on preschool grounds. This facility is providing Incidental Medical Services – IMS Plan , however, none of the children are taking medications.

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Anna Morales
LICENSING EVALUATOR SIGNATURE:	DATE: 05/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2023

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: BRIARWOOD CHILDREN'S CENTER/STATE PRESCHOOL	FACILITY NUMBER: 430703788
	VISIT DATE: 05/03/2023

NARRATIVE

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LPA observed fully fenced playground area. Observed climbing structures and with materials that observe falls. Shade is provided. The children use there own water bottles, and the water is also provided by the school. Playground is age appropriate. Breakfast, lunch and snacks are provided by the school district.

LPA reviewed a random selection of children files. Children records reviewed include , Identification and Emergency Contact, Personal Rights, Medical Assessment and Immunization Record.

LPA reviewed a random selection of Staff records reviewed include Health Screening Report and TB test, and Immunization (Measles, Pertussis, and Flu) record and current Mandated Reporter Training. LPA reminded Staff hat the online AB1207 Mandated Reported Training needs to be renewed every two years. There was at least one person with current certification in Pediatric CPR and First Aid present at the facility.

LPA discussed the requirements of AB 633 with the Licensee. Director understands the AB 633 fact sheet/copy of Acknowledgement of Receipt of Licensing Reports (LIC 9224). LPA discussed "zero tolerance" related regulations with the Director and advised the Director of the assessment of an immediate $500 per day civil penalty for any violation of a "zero tolerance" related regulation. An ongoing civil penalty of $100 per day continues until the violation(s) is corrected.

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Anna Morales
LICENSING EVALUATOR SIGNATURE:	DATE: 05/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2023

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: BRIARWOOD CHILDREN'S CENTER/STATE PRESCHOOL	FACILITY NUMBER: 430703788
	VISIT DATE: 05/03/2023

NARRATIVE

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NOTICE OF SITE VISIT WAS ISSUED. DIRECTOR WAS INFORMED TO POST THE NOTICE IN A VISIBLE LOCATION OF THE DAY CARE FOR A PERIOD OF 30 DAYS.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Anna Morales
LICENSING EVALUATOR SIGNATURE:	DATE: 05/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2023

LIC809 (FAS) - (06/04)

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