434406720-9-28-2022-07-CC-PHEZ-CJPPXL-20220928114230

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434406720
Report Date: 09/28/2022
Date Signed: 09/28/2022 11:42:43 AM

Document Has Been Signed on 09/28/2022 11:42 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-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME:	CATALYST KIDS - BACHRODT		FACILITY NUMBER:	434406720
ADMINISTRATOR:	IMELDA LLORIN		FACILITY TYPE:	850
ADDRESS:	102 SONORA AVENUE		TELEPHONE:	4084530511
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95110
CAPACITY:	24	CENSUS: 1	DATE:	09/28/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:50 AM
MET WITH:	Imelda Llorin		TIME COMPLETED:	12:05 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) Pietro Hernandez conducted an unannounced Required 1 Year inspection of Bachrodt Child Development Center today. The preschool is located on the premises of Walter L. Bachrodt Elementary School. This program is part of the San Jose Unified School District's Title 5 Program. LPA met with Site Supervisor, Imelda Llorin and explained the purpose of today's visit. Facility’s License, Parents’ Rights Poster PUB393, Personal Rights, Activity Schedules, and Menus were observed to be posted. Facility's operating days and hours are Monday to Friday 9:15 AM to 12:15 PM in a portable structure identified as F5. No preschool children were present during this inspection because LPA arrived in the afternoon after the 3 hour program had completed. This room is used by school age children from the Elementary school in the afternoons and they were arriving at the time of inspection. LPA observed 2 Teachers, 1 Director and 1 preschool child at the time of the inspection. There are active waivers on file for: Commingling of 2 programs which share indoor and outdoor space The physical plant was inspected. LPA toured the building with the Site Supervisor. Indoor space: The classroom, two children restrooms and office area were inspected. All cabinets, drawers, and rooms used for storage were locked. Furniture and equipment were age appropriate and in good condition, free of sharp, loose, or pointed parts. Restrooms for children were observed to be in safe, sanitary, and functioning condition. Floors were clean and free from tripping hazards. Foods and beverages were stored safely. Food storage area were clean, free of litter, rubbish, and rodents/vermin. Trash cans for solid waste had tight-fitting covers on and were in good repair. Site Supervisor stated that facility does not possess nor store any weapons on the premises. LPA observed a 3A40BC Fire extinguisher, Smoke and Carbon Monoxide Detectors, fire pull stations, and sprinkler system. Log shows that the last Fire Drill was conducted on 9/28/22. There was an actual school practice drill at the time of the inspection.

SUPERVISOR'S NAME: Gladys Kuizon	TELEPHONE: (408) 314-5102
LICENSING EVALUATOR NAME: Pietro Hernandez	TELEPHONE: (408) 598-9250
LICENSING EVALUATOR SIGNATURE:	DATE: 09/28/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2022

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 3

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: CATALYST KIDS - BACHRODT	FACILITY NUMBER: 434406720
	VISIT DATE: 09/28/2022

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
26
27
28
29
30
31
32

Site Supervisor told the LPA she has a private cleaning company, Salazar Cleaning, come in on a daily basis to clean and disinfect.

Facility does not provide transportation for children, but Imelda understands that children cannot be left alone, unattended in parked vehicles.

Outdoor Space: Outdoor playground was inspected and observed to be safe. The play equipment was maintained in good condition and free of hazards. Areas around and under high climbing equipment and slides were cushioned with material that absorbs falls. There were no bodies of water observed. Drinking water is available to children by water fountains and water bottles during indoor and outdoor activities.

File Review: Currently there is only 1 children enrolled. Children sign in and out procedures and logs were reviewed. A review of 1 Children's files and 4 Staff files was taken for review. All child files contained Admission Agreements, immunization's, Physician's and Parent's Health Report . Staff files contained appropriate educational units. There was at least one Teacher with current certification in Pediatric CPR and First Aid present at the facility during inspection. Children's Roster was reviewed, and a copy obtained.

Site Supervisor stated that facility does handle medications and currently has one child in care who requires Incidental Medical Services. Facility has an approved IMS Plan on file with San Jose Regional Office. LPA reviewed storage of medication and equipment / supplies. Isolation of sick children was discussed. Imelda states that she separates a sick child; usually in her office. A sick child will use one of the two children's bathrooms which is cordoned off for the time and later sanitized and cleaned. LPA advised that a staff restroom may be used instead. Child is always under visual supervision while being cared for.
The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

SUPERVISOR'S NAME: Gladys Kuizon	TELEPHONE: (408) 314-5102
LICENSING EVALUATOR NAME: Pietro Hernandez	TELEPHONE: (408) 598-9250
LICENSING EVALUATOR SIGNATURE:	DATE: 09/28/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2022

LIC809 (FAS) - (06/04)

Page: 2 of 3

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: CATALYST KIDS - BACHRODT	FACILITY NUMBER: 434406720
	VISIT DATE: 09/28/2022

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
26
27
28
29
30
31
32

LPA reminded Imelda of the applicable civil penalties for those adults who have not received fingerprint clearances, are not associated to the license, and who come in contact with or provide care and supervision to the children. For an initial violation, civil penalty amounts to $100.00 per person per day with a maximum of $500.00 per person. For a subsequent violation within a 12-month period, civil penalty amounts to $100.00 per person per day with a maximum of $3000.00 per person. Site Supervisor is encouraged to visit the Department’s website at www.cdss.ca.gov to access resources for Providers, Title 22 Regulations, Online option to pay Annual License fee, Adoption of new Laws, etc.

LPA also provided the e-mail address for the advocates in order to be added to the quarterly newsletter mailing list, childcareadvocatesprogram@dss.ca.gov

Licensee has a current Mandated Reporter Certificate that expires on 3/10/2024. All staff have current Mandated Reporter certificates.
Licensee's CPR / First Aid Card is current and expires on 9/24/24 Licensee understands at least one person needs to have a current CPR/1st Aid card when the children are present.

Licensee provided a copy of the children's roster.

Type A language: Upon the issuance of Type A citations, a copy of the Facility Evaluation Report LIC809 has to be posted on the wall and a copy to be given to all parents of currently and newly enrolled children for next 12 months. In addition, copy of LIC9224 Statement Acknowledging Receipt of Licensing Reports need to be signed and kept in child files.

A deficiency is NOT being cited based on the LPA observation, interviews conducted, and record review in accordance with the California Code of Regulations, Title 22, An exit interview was conducted was reviewed with the licensee. A copy of this report was discussed and left with the Licensee, Imelda Llorin , whose signature on this form confirm receipt of these documents.

A NOTICE OF SITE VISIT WAS ISSUED, POSTED NEAR THE ENTRANCE TO THE FACILITY, AND MUST REMAIN POSTED FOR 30 DAYS.

SUPERVISOR'S NAME: Gladys Kuizon	TELEPHONE: (408) 314-5102
LICENSING EVALUATOR NAME: Pietro Hernandez	TELEPHONE: (408) 598-9250
LICENSING EVALUATOR SIGNATURE:	DATE: 09/28/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2022

LIC809 (FAS) - (06/04)

Page: 3 of 3