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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434410602
Report Date: 07/02/2024
Date Signed: 07/02/2024 01:38:53 PM

Document Has Been Signed on 07/02/2024 01:38 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 CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:LIFE CONNECTIONS LEARNING CENTER - KINDERCAREFACILITY NUMBER:
434410602
ADMINISTRATOR/
DIRECTOR:		TIFFANY BRUNNINGSFACILITY TYPE:
840
ADDRESS:3571 NORTH FIRST STREETTELEPHONE:
(408) 424-3500
CITY:SAN JOSESTATE: CAZIP CODE:
95134
CAPACITY: 60TOTAL ENROLLED CHILDREN: 60CENSUS: 24DATE:
07/02/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:15 PM
MET WITH:Tiffany BrunningsTIME VISIT/
INSPECTION COMPLETED:
02:00 PM
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Licensing Program Analyst (LPA) Mel Matos met with Tiffany Brunnings, executive director, for an unannounced case management investigation in response to an unusual injury that the Facility self reported to the Department on June 24, 2024.

Tiffany states that the incident occurred when a school age child (6 years old) fell while running on top of the "gross-motor set" in the Central Park indoor open area of the Facility. Tiffany states that the child hit the back of his head on a bench as a result of the fall. Tiffany states that there were 16 school age children with 2 teachers at the time of the incident.

Tiffany states that first aid was applied to the child's head after the fall and the child's parents were called. Tiffany states that the child was taken to urgent care by the child's parent. Tiffany states that the child received two staples on the child's head as a result of the incident. Tiffany states that the child was kept at home for the rest of the week and returned on Monday July 1, 2024. Tiffany states that the child has no restrictions and is doing fine.

LPA toured the Central Park area, observed the "gross-motor set", and reviewed the specifications of the "gross-motor set". The "gross-motor set" is safe and age appropriate for children ages 3-6 years.

Exit interview conducted and report was reviewed with the executive director, Tiffany Brunnings. No deficiencies issued during today's investigation.

Notice of site visit was issued and must remain posted for 30 days.

SUPERVISORS NAME: Belinda Devall
LICENSING EVALUATOR NAME: Melvin S Matos
LICENSING EVALUATOR SIGNATURE: DATE: 07/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/02/2024
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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