430710536-6-3-2024-07-CC-AMOS-D5VL5F-20240603082704

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 430710536
Report Date: 05/31/2024
Date Signed: 06/03/2024 08:27:23 AM

Document Has Been Signed on 06/03/2024 08:27 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:	RODRIGUEZ, JEANINE		FACILITY TYPE:	850
ADDRESS:	375 SOUTH THIRD STREET		TELEPHONE:	(408) 295-4011
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95112
CAPACITY:	67	CENSUS: 22	DATE:	05/31/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	11:45 AM
MET WITH:	Lucille Gabriel/Betty Robles		TIME COMPLETED:	03:40 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 Unannounced Annual Random Inspection. LPA was greeted by Program Director Lucille Gabriel and Site Director Betty Robles. Days and hours of operation is Monday- Friday 7:00am-6:00pm: ages from 18 months(Toddler Component) to entry to First Grade. 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. Last disaster drill was conducted on May 17, 2024. Facility has a waiver for shared usage of outdoor space with the toddlers. The facility operates on two separate floors. At this present time, the classroom upstairs and playground is not operating. The infant program (434400382) ,the toddler option and preschool classrooms are on the first floor. LPA observed that the facility was operating in compliance with children to teacher ratio requirement. LPA observed charged Fire extinguishers and Carbon Monoxide detector. The fire alarms and smoke detectors are interconnected/hardwired. 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 playground structure. 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.

SUPERVISOR'S NAME: Gladys Kuizon	TELEPHONE: (510) 566-5850
LICENSING EVALUATOR NAME: Anna Morales	TELEPHONE: (408) 334-8325
LICENSING EVALUATOR SIGNATURE:	DATE: 05/31/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/31/2024

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: YWCA DAVIDSON	FACILITY NUMBER: 430710536
	VISIT DATE: 05/31/2024

NARRATIVE

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Drinking water was readily available to children indoor and outdoor. Activities schedule, Breakfast, lunch and Snack Menu were posted. Facility provides and prepares food (breakfast, lunch and snacks in the morning and in the afternoon). LPA provided the Program Director with website resources on managing food allergies at school and handling medical emergencies related to food allergies.
CDC Managing Food Allergies at School
https://www.cdc.gov/healthyschools/foodallergies/index.htm
American Academy of Pediatrics Healthy Children Medical Emergencies
https://www.healthychildren.org/English/health-issues/injuries-emergencies/Pages/When-to-Call-Emergency-Medical-Services-EMS.aspx

This facility provides Incidental Medical Services – IMS. Director stated that none of the children are not taking any medications at this time. For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 and link to publication. Commonly Asked Questions about Child Care Centers and the ALPDA are available at: https://www.ada.gov/resources/child-carecenters/.

LPA observed sign in and sign out system, that is updated throughout the day, containing full signatures from responsible parties. The facility maintains an updated roster of children enrolled in the program.

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 Immunizations.

Staff records reviewed include 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.

SUPERVISOR'S NAME: Gladys Kuizon	TELEPHONE: (510) 566-5850
LICENSING EVALUATOR NAME: Anna Morales	TELEPHONE: (408) 334-8325
LICENSING EVALUATOR SIGNATURE:	DATE: 05/31/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/31/2024

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: YWCA DAVIDSON	FACILITY NUMBER: 430710536
	VISIT DATE: 05/31/2024

NARRATIVE

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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.

Director was informed of the MyChildCarePlan.org website; a
consumer education website that helps families obtain childcare by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

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 also reviewed with Director the violations that would result in an immediate assessment of civil penalty in the amount of $500. Director is encouraged to visit the Department’s website at www.cdss.ca.gov to access resources for Providers, Regulations, Online option to pay Annual License fee, Adoption of new Laws, etc

No deficiencies were cited at today's inspection. Exit interview was conducted and reviewed with Director. Notice of site visit was given and must remain posted for 30 days.
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.

SUPERVISOR'S NAME: Gladys Kuizon	TELEPHONE: (510) 566-5850
LICENSING EVALUATOR NAME: Anna Morales	TELEPHONE: (408) 334-8325
LICENSING EVALUATOR SIGNATURE:	DATE: 05/31/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/31/2024

LIC809 (FAS) - (06/04)

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