<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 430709268
Report Date: 01/09/2025
Date Signed: 01/10/2025 09:22:27 AM

Document Has Been Signed on 01/10/2025 09:22 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:LOTUS PRESCHOOLFACILITY NUMBER:
430709268
ADMINISTRATOR/
DIRECTOR:		LYNNE YAMAICHIFACILITY TYPE:
850
ADDRESS:639 NORTH FIFTH STREETTELEPHONE:
(408) 293-1612
CITY:SAN JOSESTATE: CAZIP CODE:
95112
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 21DATE:
01/09/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:10 PM
MET WITH:Lynne YamaichiTIME VISIT/
INSPECTION COMPLETED:
04:05 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 visit and was greeted by Director Lynne Yamaichi. The preschool is licensed in Classrooms Dharma(Classroom One) and a Part- time classroom (Classroom Two). The Dharma classroom is a full-time classroom. The Part Time classroom is opened Monday-Friday. Hours of operation are 7:30-5:30pm, Monday to Friday. Last Disaster Drill was conducted on 10/1/24.

Director 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.

LPA toured the indoor and outdoor of the facility with Staff. Observed the required postings Facility's License, Notification of Parents’ Rights Poster, Child Car Seat Law, Personal Rights (LIC 613A), Emergency Disaster Plan, and Earthquake Preparedness Checklist were observed to be posted. Disaster Drill was conducted on 10/1/24. Children sign in and out procedures and logs were reviewed.

LPA observed that the facility was operating in compliance with teacher to children ratio requirement. Children were napping with supervision of staff. If a child comes to the facility who exhibit symptoms of illness including, but not limited to, fever or vomiting, they are not accepted into care. Any child who becomes ill during the day, shall be isolated in an empty room.
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Anna Morales
LICENSING EVALUATOR SIGNATURE: DATE: 01/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/09/2025
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 3
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: LOTUS PRESCHOOL
FACILITY NUMBER: 430709268
VISIT DATE: 01/09/2025
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
26
27
28
29
30
31
32
Children bring their own meals. Morning and afternoon snacks are provided by the preschool children. Drinking water is available and children have their won individual water bottles for indoor and outdoor areas of the facility.

LPA observed charged Fire extinguishers. LPA observed Carbon and Smoke detector. Foods and beverages were kept protected against contamination and spoilage. Trash cans for solid waste had tight-fitting covers on and were in good repair. Outdoor activity spaces are enclosed by fencing and are observed to be free of hazards. LPA observed play equipment were in good condition. LPA observed shade provided by canopy cover and patio. Activities schedule were posted. LPA observed that food storage areas were clean and free of litter.

Facility provides Incidental Medical Services – IMS. LPA was informed that there children present taking any medications. For IMS information see PIN22-02-CCP. he following information regarding ADA was provided: US Department of Justice(USDOJ) toll-free ADA information Line at (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/.

A sampling of children and staff files was taken for review during today's inspection. Children records reviewed include Admission Agreement, Identification and Emergency Contact, Consent for Emergency Medical Treatment form, receipt of Parent Rights Notice, Personal Rights Notice, Medical Assessment and Immunization's.

Staff records reviewed include Criminal Record and Child Abuse Index Clearance, Health Screening Report and TB test, Immunization (Measles, Pertussis, and Flu) record and required Training. LPA reminded Director that 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.
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Anna Morales
LICENSING EVALUATOR SIGNATURE:

DATE: 01/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/09/2025
LIC809 (FAS) - (06/04)
Page: 2 of 3
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: LOTUS PRESCHOOL
FACILITY NUMBER: 430709268
VISIT DATE: 01/09/2025
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
26
27
28
29
30
31
32
Water lead testing was completed by the facility and no Action Level Exceedances were reported. 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. LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP. LPA provided Director with the Water Lead Report from the California State Water resources Control Board during today's inspection.


A copy of this report was provided to the facility at the conclusion of the inspection. In the areas that were evaluated, there were no deficiencies cited.

Director 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 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: 01/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/09/2025
LIC809 (FAS) - (06/04)
Page: 3 of 3