434408885-1-9-2023-07-CC-PHEZ-CMWSPD-20230109130258

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434408885
Report Date: 01/09/2023
Date Signed: 01/09/2023 01:03:07 PM

Document Has Been Signed on 01/09/2023 01:03 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:	YMCA-MCAULIFFE		FACILITY NUMBER:	434408885
ADMINISTRATOR:	KIERRA MCCLANAHAN		FACILITY TYPE:	840
ADDRESS:	12211 TITUS AVENUE, ROOM 24		TELEPHONE:	(408) 351-6422
CITY:	SARATOGA	STATE: CA	ZIP CODE:	95070
CAPACITY: 53	TOTAL ENROLLED CHILDREN: 53	CENSUS: 0	DATE:	01/09/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Christian Fontanillo		TIME COMPLETED:	01:30 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 01/09/2023: Licensing Program Analyst (LPA) Pete Hernandez conducted an unannounced Required 1 Year inspection of YMCA McAuliffe today. The center is located on the premises of McAuliffe Elementary School in room identified as #24. LPA met with Site Director, Christian Fontanillo and explained the purpose of today's visit. Facility’s License, Parents’ Rights Poster PUB393, Personal Rights, and Activity Schedules, were observed to be posted. Facility's normal operating days and hours are Monday to Friday 2:00 PM to 6:00 PM. The physical plant was inspected. LPA toured the building with the Director. Indoor space: The classroom, 2 restrooms and office area were inspected. LPA observed 0 children , (because LPA arrived prior to normal business hours), and Site Director present during inspection. Facility was in compliance with teacher to children ratio requirement. LPA did not observe disinfectants, cleaning solutions or chemicals that are dangerous to the health and safety of children. All other cabinets and drawers, used for storage were locked. There were 2 first aid kits in the room. Furniture and equipment were age appropriate and in good condition, free of sharp, loose, or pointed parts. Restroom for children were observed to be in safe, sanitary, and functioning condition. Floors were clean and free from tripping hazard. 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. Director stated that facility does not possess nor store any weapons on the premises. LPA observed a 2A10BC Fire extinguisher, working Smoke and Carbon Monoxide Detectors. Log shows that the last Fire Drill was conducted on 12/22/22. Facility does not provide transportation for children, but Director understands that children cannot be left alone, unattended in parked vehicles. REPORT CONTINUED ON THE FOLLOWING PAGE (REPORT DATED 1/09/2023):

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Pietro Hernandez
LICENSING EVALUATOR SIGNATURE:	DATE: 01/09/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/09/2023

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

FACILITY NAME: YMCA-MCAULIFFE	FACILITY NUMBER: 434408885
	VISIT DATE: 01/09/2023

NARRATIVE

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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 arranged to be readily available children during indoor and outdoor activities.

File Review: Children sign in and out procedures and logs were reviewed. The sign in and out is all done electronically. A print out was provided. A sampling of 10 Children's files and 2 Staff files were taken for review. All staff files were complete. All child files contained immunization's, Physician's and Parent's Health Report. Staff files contained appropriate educational units. The Site Director has current certification in Pediatric CPR and First Aid present at the facility during inspection. Christian Fontanillo card expires 2/26/24. Children's Roster was reviewed. A copy was provided to the LPA.

Director stated that facility does handle medications and currently only no child in care who requires Incidental Medical Services. Incidental Medical Services (IMS) policy was discussed. The facility has an IMS program on file with the CCLD.

Site Director 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.

Isolation of sick child was discussed, and Director explained that a sick child is brought to the office area to be isolated from other children. A Staff restroom is used and is off limits to other children is located next to the office is used if necessary. Child is always under visual supervision while in the facilities care.

REPORT CONTINUED ON THE FOLLOWING PAGE (REPORT DATED 01/09/2023):

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Pietro Hernandez
LICENSING EVALUATOR SIGNATURE:	DATE: 01/09/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/09/2023

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: YMCA-MCAULIFFE	FACILITY NUMBER: 434408885
	VISIT DATE: 01/09/2023

NARRATIVE

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A review of Staff records indicates that all persons that require a caregiver background checks have received criminal record and child abuse index clearance or exemptions. LPA informed Licensee of the applicable civil penalties for any adult who has not received fingerprint clearances, is not associated to the license and who comes in contact with or provides 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 violation within a 12- month period.

Snacks are provided to the children. There was a monthly menu posted at the time of the inspection. All staff had current Mandated Reporter Certificates on file.

Website for provider resources:
http://www.cdss.ca.gov/inforesources/Community-Care/Self-Assessment-Guides-and-Key-Indicator-Tools/Quarterly-Updates

childcareadvocatesprogram@dss.ca.gov

SHOULD there ever be issuance of Type A citations today, 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. A copy of this report and appeals rights were discussed and left with the Site Director, Christian Fontanillo, whose signature on this form confirms 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.

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Pietro Hernandez
LICENSING EVALUATOR SIGNATURE:	DATE: 01/09/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/09/2023

LIC809 (FAS) - (06/04)

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