434408782-8-3-2022-07-CC-AALZ-CGXRB8-20220803125216

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434408782
Report Date: 07/21/2022
Date Signed: 08/03/2022 12:54:06 PM

Document Has Been Signed on 08/03/2022 12:54 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:	KIDDIE ACADEMY OF SAN JOSE		FACILITY NUMBER:	434408782
ADMINISTRATOR:	MARIE NUNEZ		FACILITY TYPE:	840
ADDRESS:	521 WEST CAPITOL EXPRESSWAY		TELEPHONE:	(408) 978-1500
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95136
CAPACITY: 21	TOTAL ENROLLED CHILDREN: 21	CENSUS: 21	DATE:	07/21/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:15 AM
MET WITH:	Nunez, Marie		TIME COMPLETED:	01:30 PM

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On this day Licensing Program Analysts (LPA/s) Almaraz and Mac, Dung conducted an annual random inspection. Due to COVID- 19 precautionary measures were taken. This facility is currently licensed for a capacity of 21. Licensing staff met with Director Nunez, Marie and explained the nature of today’s inspection. This is a School Age program that currently operates from 7:30 AM to 6:30 PM, Monday thru Friday. Licensing staff was taken on a guided tour of the facility of both indoors and outdoors. At the initial start of this visit, there is a total census of 21 children and a total census of 2 staff, teacher/s and/or assistant/s present. Director states that there are currently 21 children enrolled. This is a triple component facility, infant programs 434408783 and Preschool 434408781 on campus. All required postings were observed in entrance way to the facility.

Physical Plant:
This program consists of one classroom: Camp Adventures (Summer Camp Program): LPAs observed Staff # 1, a fully qualified teacher and staff # 2 an assistant with 21 school aged children. Teacher child ratios were observed, and staff names recorded. Personal rights observed. There is access to two sinks. Classroom observed to have suitable furniture and equipment, which were inspected for age appropriateness. All classrooms observed to have sufficient telephone services, heating, lighting, and ventilation. Children have their own cubby to store their belongings. Per Director sick children are isolated in the director's office. All storage containers for solid waste, including moveable trash receptacles have tight-fitting covers that are kept on, and in standard condition. General sanitation was observed.

Availability of indoor drinking water was observed in classrooms. Disinfectants, cleaning solutions, medication and other hazardous items that pose a risk to children, were inaccessible to the children in care. Director states that poisons are locked in the custodial room closet.

Kitchen: All kitchen areas/food preparation areas and food storage areas are kept clean and are free of litter, rubbish, rodents, and/or any other vermin. All storage containers for solid waste, including moveable trash receptables have tight-fitting covers that are kept on, and in standard condition. Water and refrigerator temperatures in standard condition. 1/4

SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Araceli Almaraz
LICENSING EVALUATOR SIGNATURE:	DATE: 07/21/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2022

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: 434408782
	VISIT DATE: 07/21/2022

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Director states waste is to be discarded immediately after each meal. Menus are posted one week in advance in each classroom and are emailed to parents. Menus for the past one year are available upon request. Snacks (AM/PM) and lunch are provided and were reviewed for availability, quantity and appropriateness to children in care. Per Director, facility belongs to a Child Care Adult food program with the State of California. All meals are prepared daily on site. Children may bring their own food. Per Director there is an allergy list for each child kept in each classroom.

Medical & First Aid Supplies: There is a first aid kit in the main office. There is a First Aid Backpack in the classroom. Per Director According medication is only administered to a child when accompanied with a doctor's note and is stored in the office. Incidental Medical Services (IMS) policy was discussed. Per Licensee there are currently no children enrolled who required IMS. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. 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

Fire & Safety: Carbon monoxide detectors and smoke detectors are working and present in the facility. There is a Fire extinguisher size 3A40BC in proximity to this room last serviced 06/08/2022; a last fire drill was conducted on 05/26/22, Director understands this is to be completed every six months.

Lavatories: There are a total of one lavatory: Bathroom one: There is a bathroom, with one toilet with a sink inside of it, within the classroom. There is also access to one toilet designated for the school age children in the preschool bathroom # 2; LPAs observed age-appropriate sink/s and toilet/s, available to the children in care and in working condition. LPA inspected bathroom water temperature, toilet paper, area safety and sanitation. There are a total of two toilets and two sinks in the bathroom/lavatories (4 water basins total) available for the children throughout this facility. LPAs observed the children's sinks are in working condition and meet licensing standards. LPA observed soap and disposable towels in the school age bathrooms. Staff has one separate bathroom that can be utilized by sick children if necessary.

Outdoor Playground: Equipment is in safe condition, free of sharp, defective or pointed parts. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. All areas around or under high climbing equipment, swings, slides, and similar equipment are cushioned with sand material that absorbs a fall. There is adequate shade in the play yard. Availability of outdoor drinking water was observed. Director states that this play area is used also used for preschooler children. Supervision and different schedules ensure there is no commingling. 2/4

SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Araceli Almaraz
LICENSING EVALUATOR SIGNATURE:	DATE: 07/21/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2022

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: 434408782
	VISIT DATE: 07/21/2022

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LPAs discussed the following: There must be a sign on the school age stall in bathroom two (for preschoolers) stating "School age only". Director understands supervision must be ensured when school age children use this stall. The stall door must be closed while in use to provide privacy. Director states during summer preschool and school age children commingle for 30 minutes while eating breakfast, a waiver must be requested if one cannot be located. An LPA review of electronic records and file review did not locate one. Director states it is believed there is one, LPAs will follow up. Facility must maintain a preschool regulations during commingling. The original license permitted sharing of the playground with preschoolers, see LIC 809 dated 06/29/2006; however a waiver may be required for this purpose. LPAs will follow up with Licensing Program Manager (LPM).

Facility Records: LPA/s issued Review of Staff records (LIC 859) to the Director during this inspection. At least one staff has record of CPR and First Aid, valid until 08/2023. All staff presents have the following: MMR & Tdap vaccinations, as well as opt out for flu vaccine. Mandated Reporter Training, valid through 2024. Directors understand this must be renewed every two years.

LPA/s reviewed 2 children's files and observed current and updated records and the Family Child Care Home Notification of Parents' Rights forms (LIC 995A) in each file. publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process.

Director was reminded that all adults 18 and over, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

SB792 (Immunization Requirements for Staff and Employees) was discussed with the facility representative.

AB1207 Mandated Child Abuse Reporting – On or before March 30, 2018 any person who works in a childcare facility shall complete the training and renew the training every 2 years. Website provided: https://www.mandatedreporterca.com/training/child-care-providers. 3/4

SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Araceli Almaraz
LICENSING EVALUATOR SIGNATURE:	DATE: 07/21/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2022

LIC809 (FAS) - (06/04)

Page: 3 of 4

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: 434408782
	VISIT DATE: 07/21/2022

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·The following was discussed:
Reporting Requirements.The facility shall ensure that each child is accorded the following personal rights: to be accorded safe, healthful and comfortable accommodations.

·All personnel shall be in good health and shall be physically and mentally capable of performing assigned tasks; personnel that pose a threat to the health and safety of children shall be relieved of their duties.

All personnel shall be given on the job training in housekeeping, sanitation principles and universal health precautions.

LPA advised the facility representative to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov.

There are no deficiencies being cited in accordance with Title 22 of the California Code of Regulations and Health & Safety codes.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with facility representative, 4/4

SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Araceli Almaraz
LICENSING EVALUATOR SIGNATURE:	DATE: 07/21/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2022

LIC809 (FAS) - (06/04)

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