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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 430710486
Report Date: 12/04/2024
Date Signed: 12/05/2024 03:48:22 PM

Document Has Been Signed on 12/05/2024 03:48 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 CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:WOOL CREEK HEAD STARTFACILITY NUMBER:
430710486
ADMINISTRATOR/
DIRECTOR:		SANDY MCKEITHANFACILITY TYPE:
850
ADDRESS:645 WOOL CREEK DRIVETELEPHONE:
(408) 573-4091
CITY:SAN JOSESTATE: CAZIP CODE:
95112
CAPACITY: 74TOTAL ENROLLED CHILDREN: 74CENSUS: 35DATE:
12/04/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Dee VoTIME VISIT/
INSPECTION COMPLETED:
12:45 PM
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Licensing Program Analyst (LPA) Anna Morales, conducted an unannounced annual required and was met by Director Dee Vo. The Preschool is licensed in Rooms 2, 3 and 4. At this time, Classroom #2 is not open. Classroom #3 and #4 are currently being used. In Classroom #3, there are 19 students present, one teacher and two associated teachers. Classroom #4, 16 students, one teacher and two associated teachers. Facility was observed to be in compliance with teacher to child ratio requirement during visit. Hours for Room 3 for Room 4, from 8:30-2:30pm.( staff hours are 8am- 5:00pm). 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 November 6 and November 24, 2024.

The Preschool serves breakfast and lunch which is delivered by a third party.

LPA discussed the requirements of AB 633 with the Director. The 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.

The program is operated by the Santa Clara Unified School District and all criminal background checks for staff are handled by the Department of Education and thus do not come under the jurisdiction of Community Care Licensing Division.
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Anna Morales
LICENSING EVALUATOR SIGNATURE: DATE: 12/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/04/2024
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: WOOL CREEK HEAD START
FACILITY NUMBER: 430710486
VISIT DATE: 12/04/2024
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A Fully charged, 2A 10BC Fire extinguishers were observed in the classrooms. The Carbon monoxide detectors are interconnected with the smoke alarms located on the ceilings. 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.

Drinking water was observed to be readily available for children in each room and in the outdoor playground area via individual water bottles. 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.

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



LPA reviewed a random selection of children files. Children records reviewed include, Identification and Emergency Contact, Medical Assessment and Immunization.
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 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: 12/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/04/2024
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: WOOL CREEK HEAD START
FACILITY NUMBER: 430710486
VISIT DATE: 12/04/2024
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The facility provides Incidental Medical Services-IMS. LPA reviewed storage of of medication and equipment/supplies, and reviewed children's personnel, and administrative records. For IMS information see PIN22-02-CCP. The 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 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. Site Director informed LPA that they will be replacing the cushion/foam protector surrounding one of the poles, and replacing the absorbent material in
the playground. Site Director will contact LPA once completed.

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


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.
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Anna Morales
LICENSING EVALUATOR SIGNATURE:

DATE: 12/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

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