434410801-10-16-2023-07-CC-JBOT-CWNVPW-20231016163725

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434410801
Report Date: 10/16/2023
Date Signed: 10/16/2023 04:38:13 PM

Document Has Been Signed on 10/16/2023 04:38 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:	CREATIVE MINDS CHILD DEVELOPMENT CENTER		FACILITY NUMBER:	434410801
ADMINISTRATOR:	RICHA D. KAPUR		FACILITY TYPE:	850
ADDRESS:	4977 DENT AVENUE		TELEPHONE:	(408) 445-0101
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95118
CAPACITY: 64	TOTAL ENROLLED CHILDREN: 35	CENSUS: 28	DATE:	10/16/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Richa Kapur		TIME COMPLETED:	05:00 PM

NARRATIVE

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Licensing Program Analyst (LPA) Jessica Bongardt and Licensing Program Manager (LPM) Diana Stephenson met with Richa Kapur, Director, for an unannounced Required - 1 Year inspection. LPA and LPM toured the indoor and outdoor areas of the Facility with Director during today's inspection. LPA and LPM 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), and Activity Schedule. Days and hours of operation are Monday through Friday 8:15AM to 5:00PM. The facility is licensed to serve a maximum of 64 children ages two to five years old.

LPA and LPM reviewed eight children's files and eight staff files during today's inspection. Each child's file reviewed contains all required forms/documents, including Admission Agreement, Emergency Medical Consent (LIC 627), and Information and Emergency Information form (LIC 700). Staff files reviewed six out of eight did not have their flu vaccine on file, one does not have their current TB Test on file. LPA and LPM verified transcripts/verification of experience. One out of eight staff is missing their certificate of completion of the Mandated Reporter Training for Child Care Workers 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). Last fire/disaster drill was completed on 09/23/2023.

LPA and LPM observed that the teacher/child ratio was in compliance during today's inspection. LPA and LPM observed 35 Children and seven staff during today's inspection. Director understands the conditions, limitations, and capacity specifications of the Facility license. Richa 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.

LPA observed that the Facility is clean, safe, sanitary, and in good repair for children, staff, and visitors. (director) states that the Facility has private janitorial service everyday. Director understands that the Facility must be kept free of flies and other insects & rodents. LPA observed that all furniture and equipment is in good condition and safe for the children. Water bottles are brought from home that are labeled with each childs name, they are filled by the teachers anytime the child asks. There is water provided outside to fill the bottles as well.

SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Jessica Bongardt
LICENSING EVALUATOR SIGNATURE:	DATE: 10/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2023

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 CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: CREATIVE MINDS CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 434410801
	VISIT DATE: 10/16/2023

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LPA and LPM observed there is hot and cold running water, refrigerator, stove, two dishwashers and three microwaves on the premises. Meals and snacks are brought from home, all food is labeled with the childs name on it.. The Facility has trash cans with tight fitting lids for solid waste in the classroom. Cleaning supplies are inaccessible to the children and stored in cabinets located in areas off limits to children. LPA and LPM observed a complete first aid kit available in the facility.

The playground area utilized by children is surrounded by appropriate fencing and the outdoor surfaces are safe for the children. LPA and LPM observed that the outdoor equipment is age appropriate and in good condition. Shade rest areas are provided by trees. There is sufficient resilient materials (woodchips and grass) on the outdoor playground area. LPA and LPM did not observe any bodies of water. Director states that the Facility does not provide transportation for preschool children.

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.

This facility does not provide Incidental Medical Services. Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes 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 publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

LPA and LPM discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA and LPM also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Jessica Bongardt
LICENSING EVALUATOR SIGNATURE:	DATE: 10/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2023

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 CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: CREATIVE MINDS CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 434410801
	VISIT DATE: 10/16/2023

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Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test.

For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure 07/27/2022.

Director understands that children's personal rights should not be violated; including no unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse or other actions of a punitive nature.

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/inspection-process

LPA and LPM provided Director with website resources on managing food allergies at school and handling medical emergencies related to food allergies.

CDC Managing Food Allergies at School

https://www.cdc.gov/healthyschools/foodallergies/index.htm

American Academy of Pediatrics Healthy Children Medical Emergencies

https://www.healthychildren.org/English/health-issues/injuries-emergencies/Pages/When-to-Call-Emergency-Medical-Services-EMS.aspx

Exit interview conducted and report was reviewed with Richa, Director. Two Deficiencies were cited and appeal rights given to Director during today's inspection.

A Notice of Site Visit was given and must remain posted for 30 days.

SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Jessica Bongardt
LICENSING EVALUATOR SIGNATURE:	DATE: 10/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 10/16/2023 04:38 PM - It Cannot Be Edited

Created By: Jessica Bongardt On 10/16/2023 at 04:01 PM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: CREATIVE MINDS CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 434410801
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/16/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.7995(a)(1)

General Provisions and Definitions

(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in six out of eigth staff files were reviewed and flu vaccines were not in the files which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 12/01/2023
	Plan of Correction
1 2 3 4	Director will submit Flu Vaccines or letters of staff opting out of flu vaccine to department by POC due date.

Type B

Section Cited

CCR

101217(a)(12)

Personnel Records

(a) The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. Each personnel record shall contain the following information: (12) Tuberculosis test documents as specified in Section 101216(g). This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in one out of eight staff files that were reviewed which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 10/30/2023
	Plan of Correction
1 2 3 4	Director will submit TB test for staff by POC due date to the department

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME:

Diana Stephenson

LICENSING EVALUATOR NAME:

Jessica Bongardt

LICENSING EVALUATOR SIGNATURE:

DATE: 10/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2023

LIC809 (FAS) - (06/04)

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