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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434400312
Report Date: 10/02/2024
Date Signed: 10/02/2024 04:08:15 PM

Document Has Been Signed on 10/02/2024 04:08 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:BRIGHT HORIZONS-SAN JOSEFACILITY NUMBER:
434400312
ADMINISTRATOR/
DIRECTOR:		REBECCA ADAMSFACILITY TYPE:
830
ADDRESS:6120 LISKA LANETELEPHONE:
(408) 225-3276
CITY:SAN JOSESTATE: CAZIP CODE:
95119
CAPACITY: 32TOTAL ENROLLED CHILDREN: 27CENSUS: 21DATE:
10/02/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:59 PM
MET WITH:Tiffany BrazilTIME VISIT/
INSPECTION COMPLETED:
04:20 PM
NARRATIVE
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Licensing Program Analyst (LPA), Mandeep Kaur conducted an unannounced plan of correction inspection. LPA met with interim Assistant Director, Tiffany Brazil and purpose of the inspection was explained.

LPA toured the outdoor area of the facility with interim Assistant Director during today's inspection. LPA observed missing resilient material to observe the fall around and under the small slide in the playarea.

A type B citation was issued on August 23, 2024 regarding Outdoor Activity Space: Title 22 regulations section code: 101238.2(e)(1). Based on interviews, observations and records review, licensee has not completed the Plan of correction that was due by September 20, 2024.

During today's inspection, Type B citation was issued on attached 809-D and Civil penalties were assessed in the total amount of $1200. Civil Penalty Assessment LIC421FC was completed and signed during today's inspection. Interim Assistant Director was informed that civil penalties of $100 per day will continue until all requested items are corrected.


Exit interview conducted, appeal rights provided and report was reviewed with Interim Assistant Director, Tiffany Brazil.

A notice of site visit has been issued and must remain posted for 30 days.
SUPERVISORS NAME: Belinda Devall
LICENSING EVALUATOR NAME: Mandeep Kaur
LICENSING EVALUATOR SIGNATURE: DATE: 10/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/02/2024
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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Document Has Been Signed on 10/02/2024 04:08 PM - It Cannot Be Edited


Created By: Mandeep Kaur On 10/02/2024 at 03:46 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: BRIGHT HORIZONS-SAN JOSE
FACILITY NUMBER: 434400312

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/02/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/16/2024
Section Cited
CCR
101238.2(e)(1)(2)

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Outdoor Activity Space: (e) As a condition of licensure, the areas around and under high climbing equipment, swings, slides and other similar equipment shall be cushioned with material that absorbs falls.
(1) Sand, woodchips and peagravel, or rubber mats commercially produced for the purposes of (e) above, are permitted.
(2) The use of cushioning material other than that specified in (e)(1) above shall be approved by the Department prior to installation.
This requirement was not met as evidenced by:
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By POC 10/16/2024, facility will submit proof of work order and proof of purchase of additional resilient material to the department. Upon installation of addtional resilient material, facility will submit proof to the department.
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Based on observations, facility is missing resilient material to observe the fall around and under the small slide in the playarea, which poses potential Health, Safety, or Personal Rights risk to persons in care
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Belinda Devall
LICENSING EVALUATOR NAME:Mandeep Kaur
LICENSING EVALUATOR SIGNATURE:
DATE: 10/02/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/02/2024


LIC809 (FAS) - (06/04)
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