434403563-10-21-2025-07-CC-FRAA-DMNS3B-20251021133048

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434403563
Report Date: 10/21/2025
Date Signed: 10/21/2025 01:31:02 PM

Document Has Been Signed on 10/21/2025 01:31 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-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME:	SACRED HEART PRE-SCHOOL		FACILITY NUMBER:	434403563
ADMINISTRATOR/ DIRECTOR:	CAMARENA, JUDY		FACILITY TYPE:	850
ADDRESS:	13718 SARATOGA AVENUE		TELEPHONE:	(408) 867-9241
CITY:	SARATOGA	STATE: CA	ZIP CODE:	95070
CAPACITY: 32	TOTAL ENROLLED CHILDREN: 15	CENSUS: 15	DATE:	10/21/2025
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	08:50 AM
MET WITH:	Judy Camarena		TIME VISIT/ INSPECTION COMPLETED:	12:40 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	On 10/21/2025, Licensing Program Analyst (LPA), Farida Raja, met with Director, Judy (Judith) Camarena for an unannounced Annual/Random inspection. The facility is licensed to serve children ages 2 years 9 months to entry into kindergarten in one classroom (junior kindergarten). LPA observed all required posted materials in the classroom. Days and hours of operation are Monday through Friday, 8:00 AM to 2:45 PM. Facility has one waiver on file for shared outdoor area, adjacent to the preschool classroom, between Sacred Heart Preschool Program and the kindergarten classroom of Sacred Heart School. Director submitted a updated copy of the Emergency Disaster Plan for Child Care Centers (LIC 610) and Personnel Report (LIC 500) during today's inspection. LPA and Director toured the indoor and outdoor areas of the program during today's inspection. LPA observed 15 children and three staff including director and two teachers. Facility was in compliance with teacher to children ratio requirement. Children were observed to be engaged in circle time. Classroom, children's restroom, staff restrooms and kitchen were inspected. Facility has central heating/cooling for comfort of children. Director states that there are no weapons including firearms on the premises. There is a working telephone at the facility. Disinfectants, cleaning products and medicines were observed to be stored inaccessible to the children. Furniture and equipment were age appropriate and in good condition, free of sharp, loose, or pointed parts. LPA observed solid waste containers with swing top lids in the classroom. LPA advised director that all containers used for storage of solid wastes, shall have a tight fitting cover that is kept on; shall be in good repair; and shall be leakproof and rodent-proof. Napping equipment was observed to be appropriate. Restrooms and sinks for children were observed to be safe, sanitary, and in working condition. Continued on Page 2

NAME OF LICENSING PROGRAM MANAGER: Gladys Kuizon
NAME OF LICENSING PROGRAM ANALYST: Farida Raja
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 10/21/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2025

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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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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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-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: SACRED HEART PRE-SCHOOL	FACILITY NUMBER: 434403563
	VISIT DATE: 10/21/2025

NARRATIVE

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LPA observed a fully charged fire extinguisher, working smoke and carbon monoxide detector. Log shows that the last Fire Drill was conducted on 09/18/2025 which is compliant with the six-month requirement for facilities.

Drinking water is readily available for children indoors and outdoors via individual water bottles and refilled using an indoor drinking water fountain. Water lead testing for one drinking water fountain indoors was completed for the facility on 12/08/2022 and no Action Level Exceedances were reported. LPA informed Director that per the water lead testing report the kitchen sink and outdoor bottle refilling station were not tested and cannot be used for drinking or food preparation purposes. LPA observed that the bottle refilling station in the outdoor area is not functional.

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 referred Director to the Department website for lead: Lead Toxicity Prevention and Water Testing Information. LPA provided Director with the Water Lead Report from the California State Water Resources Control Board during today's inspection.

Parents provide all meals and snacks for the children and no food or snack is provided by the facility. Director stated that food is available for purchase through a third party vendor. Food storage area was observed to be sanitary.

Outdoor playground and play equipment was inspected and observed to be fenced in and free of hazards. LPA observed play equipment was in good condition, age-appropriate, and areas around and under high climbing equipment and slides were cushioned with resilient material. Shaded rest area is provided by canopy. There were no bodies of water observed. Per Director the play structure is appropriate for children ages 4-8 years and their program only enrolls children 4 years to entry into kindergarten. Director stated that sometimes children also use the other playground that they were initially licensed for. LPA inspected the playground and play equipment which was observed to be in good condition and cushioned with resilient material.

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NAME OF LICENSING PROGRAM MANAGER: Gladys Kuizon
NAME OF LICENSING PROGRAM ANALYST: Farida Raja
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 10/21/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2025

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-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: SACRED HEART PRE-SCHOOL	FACILITY NUMBER: 434403563
	VISIT DATE: 10/21/2025

NARRATIVE

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LPA reminded Director that the preschool and school age children cannot commingle in the outdoor area at any time and outdoor schedules submitted as part of the waiver request need to be followed. An update to the schedule to be provided to the Department in case of any changes.

Children sign in and out logs were reviewed. Children's roster was reviewed, and a copy was obtained by LPA. LPA reviewed four children’s files during today's inspection. Each child's file reviewed contained all required forms.

Three staff files were reviewed. All teachers and staff maintain valid background clearances. All staff files reviewed contain the required transcripts/verification of experience. All staff have current CPR and First Aid certification. Director understands that there shall be at least one person, with valid CPR and First Aid certifications, on site at all times or present during off-site activities (field trips). All staff have the required immunization's against pertussis, measles and influenza or statement declining influenza immunization. Staff S2 and S3 have not renewed the Mandated Reporter Training required for all staff.

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.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s records. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. LPA provided Director with a copy of PIN 22-02-CCP. Director to submit a plan of operation for IMS to LPA by 11/07/2025. Any medications at the facility are stored in a lock box in the classroom, inaccessible to children in care. Isolation of sick child was discussed, and Director explained that sick children will be isolated in the school office and isolation equipment will be provided. A staff restroom which is off limits to other children is used if necessary. Child is always under visual supervision while in care of the facility. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (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/.

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NAME OF LICENSING PROGRAM MANAGER: Gladys Kuizon
NAME OF LICENSING PROGRAM ANALYST: Farida Raja
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 10/21/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2025

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-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: SACRED HEART PRE-SCHOOL	FACILITY NUMBER: 434403563
	VISIT DATE: 10/21/2025

NARRATIVE

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Facility does not provide transportation to children. 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.

One Type B deficiency was cited as a result of today's inspection. Appeal rights provided. Exit interview conducted and report was reviewed with Director, Judy Camarena.

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

NAME OF LICENSING PROGRAM MANAGER: Gladys Kuizon
NAME OF LICENSING PROGRAM ANALYST: Farida Raja
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 10/21/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2025

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 10/21/2025 01:31 PM - It Cannot Be Edited

Created By: Farida Raja On 10/21/2025 at 12:04 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: SACRED HEART PRE-SCHOOL	FACILITY NUMBER: 434403563
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/21/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, interview and record review, the licensee did not comply with the section cited above for two staff (S2 and S3) which poses a potential health, safety or personal rights risk to persons in care. Staff S2 and S3's Mandated Reporter Training we observed to have expired and have not been renewed. LPA reminded Director that the training is to be renewed every two years.
	POC Due Date: 11/07/2025
	Plan of Correction
1 2 3 4	Director to submit certificate of completed Mandated Reporter TRaining to LPA by plan of correction date of 11/07/2025.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

	Gladys Kuizon
NAME OF LICENSING PROGRAM MANAGER:

	Farida Raja
NAME OF LICENSING PROGRAM ANALYST:

LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/21/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2025

LIC809 (FAS) - (06/04)

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