430710536-2-13-2025-07-CC-AMOS-DDUMHL-20250213083739

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 430710536
Report Date: 02/12/2025
Date Signed: 02/13/2025 08:38:03 AM

Document Has Been Signed on 02/13/2025 08:38 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:	YWCA DAVIDSON		FACILITY NUMBER:	430710536
ADMINISTRATOR/ DIRECTOR:	RODRIGUEZ, JEANINE		FACILITY TYPE:	850
ADDRESS:	375 SOUTH THIRD STREET		TELEPHONE:	(408) 295-4011
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95112
CAPACITY: 67	TOTAL ENROLLED CHILDREN: 20	CENSUS: 18	DATE:	02/12/2025
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	12:30 PM
MET WITH:	Lucille Gabriel/Betty Robles		TIME VISIT/ INSPECTION COMPLETED:	04:25 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 Analysts(LPAs)Anna Morales and Marilou Monico conducted a unannounced Case Management inspection. LPAs were met by Director Betty Robles and Executive Director Lucille Gabriel. An application was submitted to Community Care Licensing (CCL) to remove the Toddler Option (15 capacity)and decrease the capacity of the preschool from 67 capacity to 55 children. Hours of operation will be Monday- Friday, 7:00 AM -6:00 PM, ages 2 years to entry to 1st grade. During the today's inspection, LPAs measured Classroom Number 1 and Classroom Number 2( located upstairs)and two Preschool playgrounds. Preschool Classroom 1 (first floor): 23.25 x 24.58 = 571.49 25 x 20.83 = 520.75 Preschool Classroom 1 total =1,092.24 -123.83(encumbered space)=968.41 Preschool Classroom 2 (Second Floor): 35.92 x 24.33=873.93 - 52.23 (encumbered space) = 821.70 Total Preschool Indoor Space = 1,790.11 divided by 35 sq.ft.= 51 children Preschool Playground(first floor): 48.75 x 37.17= 1,812.04 7.92 x 12.58= 99.63 13.67x 8.50=116.20 TOTAL: =2,027.87 minus 6.65 (encumbered space) = 2021.22 Continue on LIC809-----

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Anna Morales
LICENSING EVALUATOR SIGNATURE:	DATE: 02/12/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2025

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: YWCA DAVIDSON	FACILITY NUMBER: 430710536
	VISIT DATE: 02/12/2025

NARRATIVE

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Preschool Playground (Second Floor):
79.75 x 33.17= 2,645.31 - 90.24(encumbered)=2,555.07
Preschool Playground(First Floor): =2,021,22
TOTAL PRESCHOOL OUTDOOR SPACE = 4,576.29 divided by 75 sq.ft.= 61 children

LPAs observed six toilets, four sinks, 53 chairs, 8 tables, 60 cubbies, 37 mats and five cots. There is a bathroom for staff located in the Older Infant classroom/hallway. The sick children will use the staff bathroom if needed and will be accompanied by a staff member. Sick children will be isolated in the Office and isolation equipment will be provided.

LPAs observed age appropriate furnishings, toys and playground equipment. The downstairs playground has absorbent material underneath the climbing equipment and there is a patio cover for shade. LPAs observed fully charged fire extinguishers and smoke/carbon detectors. Breakfast, lunch and snacks will be provided by the facility. There is a kitchen located adjacent to the Older Infant classroom for food preparation.

In the upstairs playground, LPAs observed that the fence surrounding the playground only measured 3.6ft in height and 3ft on the other side.
LPAs advised the Director's to place a fence that measures at least 4ft high.

The following items to be completed prior to licensure of 51 children in the preschool program:
1). In the upstairs Playground, place a fence that measures at least 4ft high
2). Submit photos of the Upstairs Preschool(#2)once ready
3). Submit a Facility Sketch and a new LIC200 requesting the new capacity of 51 preschool aged children
4). Fire Clearance approval for 51 children
5). Manager's review and approval.

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Anna Morales
LICENSING EVALUATOR SIGNATURE:	DATE: 02/12/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2025

LIC809 (FAS) - (06/04)

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