434408781-8-27-2021-07-CC-JCRZ-C6AS5J-20210827133421

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434408781
Report Date: 08/27/2021
Date Signed: 08/27/2021 01:34:27 PM

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:	KIDDIE ACADEMY OF SAN JOSE		FACILITY NUMBER:	434408781
ADMINISTRATOR:	MARIE NUNEZ		FACILITY TYPE:	850
ADDRESS:	521 WEST CAPITOL EXPRESSWAY		TELEPHONE:	(408) 978-1500
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95136
CAPACITY:	98	CENSUS: 36	DATE:	08/27/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:07 AM
MET WITH:	MARIE NUNEZ		TIME COMPLETED:	01:45 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 Analysts (LPA) Janette Cruz met with Marie Nunez, Director, for an unannounced Required - 1 year inspection. LPA toured the Facility (indoor and outdoor areas) during today's inspection. LPA notes that the Facility is licensed in the following rooms: Pre-K, Preschool, Jr Preschool1, Jr Preschool 2 and Kindergarten. The facility also has an infant program (#434408781) in Infant/Toddler 1 & 2 and school age program (#434408783). LPA observed the required posted materials, including the Facility License, Emergency Disaster Plan (LIC 610), Earthquake Preparedness Checklist (LIC 9148), Parents' Rights Poster (PUB 393), Personal Rights (LIC 613A), Child Car Seat Law (PUB 269), Menus, and Activity Schedule. The facility has two active waivers on file ( shared bathroom use and electronic sign-in and sign-out). The facility is currently using a sign-in sign-out sheet signed by parents. Director states electronic sign-in and sign-out is currently not in use due to COVID-19 precautions. LPA reviewed ten children's and six staff files (1 director, 4 teachers and 1 aide ) during today's inspection. Each child's file reviewed contains the Information and Emergency Information form (LIC 700) and medical assessment. Sign in and sign out sheets were reviewed and were in compliance, including legal signatures. All staff files reviewed contain the required transcripts/verification of experience/immunization records (including flu vaccine opt out forms) and Health Screening Report (LIC 501). All staff have current certificates of completion of the Mandated Reporter Training for Child Care Workers on file. LPA reviewed two teachers that have current CPR and First Aid certifications on file. 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). REPORT CONTINUED ON THE FOLLOWING PAGE (PAGE #2):

SUPERVISOR'S NAME: Diana Stephenson	TELEPHONE: (408) 324-2128
LICENSING EVALUATOR NAME: Janette Cruz	TELEPHONE: (408) 334-8312
LICENSING EVALUATOR SIGNATURE:	DATE: 08/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2021

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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: KIDDIE ACADEMY OF SAN JOSE	FACILITY NUMBER: 434408781
	VISIT DATE: 08/27/2021

NARRATIVE

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LPA observed that the teacher/child ratio was in compliance during today's inspection. Director understands the conditions, limitations, and capacity specifications of the Facility license. Director understands that children shall be visually supervised at all times. Any child(ren) who exhibit symptoms of illness including, but not limited to, fever or vomiting, are not accepted in care. Any child(ren) who become ill during the day, shall be isolated in the director’s office area. Director states that the Facility has adequate cleaning/sanitizing supplies & PPE equipment.

LPA observed that the Facility is clean, safe, sanitary, and in good repair for children, staff, and visitors. Director states that the Facility has a third-party cleaning service that cleans the Facility Monday through Friday in the evenings. Director understands that the Facility must be kept free of flies and other insects & rodents. LPAs observed that all furniture and equipment are in good condition and safe for the children. Drinking water is readily available for the children in the Facility and in the outdoor playground area via water dispensers. Staff and children's bathrooms are clean, sanitary, and operable. There is a separate staff bathroom not utilized by the children which an isolated child can use if needed. Director states that there are no weapons or firearms on the premises. The Facility has working smoke and carbon monoxide detectors.

LPA observed that the food preparation and storage areas are clean, free of litter & rubbish, and free of rodents and other vermin. All food and beverages that require refrigeration are stored in covered containers at 45 degrees F or less. The Facility has trash cans with tight fitting lids for solid waste. Cleaning supplies are inaccessible to the children and stored in locked cabinets/high shelves inaccessible to children. Director states that there are no poisons in the Facility. Director states that the Facility does not administer medication at this time.

LPA observed that there is adequate fencing surrounding the playground. The outdoor activity space is equipped with a variety of age-appropriate toys and equipment, including a play structure (which is secure and safe for the children). The area around and under the play structure has sand as cushioning material. There is shade in the outdoor space available for rest area. LPA did not observe any bodies of water during today's inspection. Director states that the Facility provides transportation.
REPORT CONTINUED ON THE FOLLOWING PAGE (PAGE #3):

SUPERVISOR'S NAME: Diana Stephenson	TELEPHONE: (408) 324-2128
LICENSING EVALUATOR NAME: Janette Cruz	TELEPHONE: (408) 334-8312
LICENSING EVALUATOR SIGNATURE:	DATE: 08/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2021

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: KIDDIE ACADEMY OF SAN JOSE	FACILITY NUMBER: 434408781
	VISIT DATE: 08/27/2021

NARRATIVE

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Licensing Forms, Title 22 Regulations and information can be obtained through the internet at www.cdss.ca.gov.

A review of staff records on August 27, 2021 indicates that all Facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. LPAs reminded Director 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. Penalty amounts: $100.00 per person per day, minimum of $100.00 to a maximum of $500.00 per person for an initial violation and a minimum of $100.00 to a maximum of $3000.00 per person for any subsequent violations within a 12 month period.

LPAs conducted an exit interview with the Director prior to the conclusion of today's inspection and advised her that no deficiencies are issued during today's inspection.

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

SUPERVISOR'S NAME: Diana Stephenson	TELEPHONE: (408) 324-2128
LICENSING EVALUATOR NAME: Janette Cruz	TELEPHONE: (408) 334-8312
LICENSING EVALUATOR SIGNATURE:	DATE: 08/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2021

LIC809 (FAS) - (06/04)

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