434404443-5-31-2024-07-CC-SYIP-D5SR64-20240531124408

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434404443
Report Date: 05/31/2024
Date Signed: 05/31/2024 12:44:15 PM

Document Has Been Signed on 05/31/2024 12:44 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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME:	TEMPLE EMANU-EL PRESCHOOL		FACILITY NUMBER:	434404443
ADMINISTRATOR/ DIRECTOR:	SMEAD, BARBARA		FACILITY TYPE:	850
ADDRESS:	1010 UNIVERSITY AVENUE		TELEPHONE:	(408) 293-8660
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95126
CAPACITY: 90	TOTAL ENROLLED CHILDREN: 90	CENSUS: 64	DATE:	05/31/2024
TYPE OF VISIT:	Case Management - Annual Continuation	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:31 AM
MET WITH:	Barbara Smead		TIME VISIT/ INSPECTION COMPLETED:	12:50 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) Samantha Yip conducted an unannounced Case Management- Annual Continuation inspection. LPA met with Director Barbara Smead and explained the reason for the inspection. The purpose of this inspection is to continue the annual/random inspection from 05/22/2024. Present during today's inspection were 64 children, at least 14 staff, and two therapist. During today's inspection, LPA inspected the physical plant. There is a carbon monoxide detector. 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. A copy of the facility roster was obtained. 12 children's files were reviewed during today's inspection. The records reviewed include but not limited to admission agreement and parent's rights. LPA discussed with Director about ensuring that the forms are the correct one, such as the LIC 999: Notification of Parent's Rights. -------------------continues on 809 dated 05/31/2024 page 2------------------------

SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Samantha Yip
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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Document Has Been Signed on 05/31/2024 12:44 PM - It Cannot Be Edited

Created By: Samantha Yip On 05/31/2024 at 11:41 AM

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: TEMPLE EMANU-EL PRESCHOOL	FACILITY NUMBER: 434404443
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/31/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Deficiency Dismissed

Type B

Section Cited

CCR

101216.3(b)

Teacher-Child Ratio

(b) The licensee may use teacher aides in a teacher-child ratio of one teacher and one aide for every 15 children in attendance. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above, which poses a potential health, safety or personal rights risk to persons in care. On 05/22/2024, S-1 was present during inspection. Transcript were not evaluated.
	POC Due Date: 05/31/2024
	Plan of Correction
1 2 3 4	Deficiency corrected during today's inspection. Director had staff get transcript evaluated during inspection and changed staffing schedule.

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.

SUPERVISOR'S NAME:

Joel Segura

LICENSING EVALUATOR NAME:

Samantha Yip

LICENSING EVALUATOR SIGNATURE:

DATE: 05/31/2024

I acknowledge receipt of this form and understand my 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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: TEMPLE EMANU-EL PRESCHOOL	FACILITY NUMBER: 434404443
	VISIT DATE: 05/31/2024

NARRATIVE

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-----------------continuation of 809 dated 05/31/2024 page 1--------------------

Seven (7) staff files were reviewed during today's inspection. The records reviewed include but not limited to education credit, health screening, and mandated reporter training. All staff have CPR/1st Aid, which expires on 04/2026.

LPA also discussed with director that any transcripts completed internationally needs to be evaluated. S-1 was present during inspection on 05/22/2024. S-1's transcript was not evaluated. The other staff with S-1 on 05/22/2024 is not a fully qualified teacher. Director had staff get transcript evaluated and changed staffing schedule during today's inspection.

All staff present during today's inspection have cleared fingerprints. Facility representative 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.

As a result of this inspection, no deficiencies were issued. Exit interview conducted and report was reviewed with Director Barbara Smead. A notice of site visit has been issued and must remain posted for 30 days.

SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Samantha Yip
LICENSING EVALUATOR SIGNATURE:	DATE: 09/19/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2024

LIC809 (FAS) - (06/04)

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