434413020-2-28-2024-07-CC-SCHN-D2W32E-20240228165146

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434413020
Report Date: 02/28/2024
Date Signed: 02/28/2024 04:52:06 PM

Document Has Been Signed on 02/28/2024 04:52 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:	SUNNYMONT-WESTSIDE PARENT CO-OP NURSERY SCHOOL		FACILITY NUMBER:	434413020
ADMINISTRATOR:	JUSTINE SAFFIR		FACILITY TYPE:	850
ADDRESS:	15040 UNION AVENUE		TELEPHONE:	4083717646
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95124
CAPACITY: 30	TOTAL ENROLLED CHILDREN: 30	CENSUS: 11	DATE:	02/28/2024
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Prudence Kolano		TIME COMPLETED:	12:45 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	Page 1. On 2/28/24 Licensing Program Analyst (LPA), Sheena Chin, conducted an unannounced Required - 3 year inspection of the nursery school. LPA met with the director, Prudence Kolano, and explained the purpose of the visit. The data from the licensing information system (LIS) did not show Ms. Kolano as the director. Ms. Kolano stated that she became the director about 2 years ago and that the LPA, who came last year for complain investigations did not have questions. The Facility is licensed to serve ages 2 years to entry into kindergarten, big kids room and toddler room. Hours of operation: 9:30 AM to 12:00 PM Monday to Friday. The director stated that pre-K kids used big kids room on Mondays, Tuesdays, Thursdays and Fridays and 2 – 3 year olds used toddler room on Mondays, Wednesdays and Fridays. The director stated that the facility did not have weapons on the premises, that smoking was not allowed on the premises and that the facility provided incidental medical services to one child in care. The director stated that the facility provided snacks to children in care. Observation LPAs toured the indoor and outdoor areas of the Facility with the director. 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 were observed. The facility passed the fire inspection on 6/14/23. The director stated that the Fire Marshall came on 2/12/24 for inspections but did not give her any documents. LPA observed that the cards on the fire extinguishers were marked on 6/14/23 only. LPA observed fully charged Fire Extinguishers, functioning smoke/carbon monoxide detectors, First Aid Kit, central heating, and air conditioning in all rooms. Furniture and equipment were observed to be age appropriate and in good condition, free of sharp, loose, or pointed parts. Disinfectants, cleaning solutions, poisons, sharps, and other items that are dangerous to children were stored inaccessible. Restrooms for children to use were observed to be in operating condition. Play equipment were maintained in a good condition, free of hazards. continue to page 2.

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Sheena Chin
LICENSING EVALUATOR SIGNATURE:	DATE: 02/28/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/28/2024

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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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: SUNNYMONT-WESTSIDE PARENT CO-OP NURSERY SCHOOL	FACILITY NUMBER: 434413020
	VISIT DATE: 02/28/2024

NARRATIVE

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Observation
The facility provided snacks and trash cans for solid waste had tight-fitting covers on. LPA observed a cage with a guinea pig in the toddler room. The director stated that the guinea pig has been in the classroom since the school started and that children could hold the guinea pig while parents watching. The director stated that most of the time children just watched the guinea pig. LPA advised the director to present the vaccinations for this animal. The director stated that the guinea pig had the last check-up on 9/26/22 and everything was normal.

The facility is a parent co-op school. 11 children with 5 parents and one director were present in toddler room during the inspection. The director stated that she understands the conditions, limitations, and capacity specifications of the Facility license and that children shall be always supervised within the classroom and in the playground areas.

The playground area was surrounded by appropriate fencing. Shade is provided by trees and umbrellas in the playground area. The outdoor equipment is age-appropriate and in good condition. There is a climbing structure in the playground that is age appropriate. Rubber surfacing is used as resilient material throughout the playground. Areas around and under high climbing equipment were cushioned with material that absorbs falls. There were no bodies of water observed.

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SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Sheena Chin
LICENSING EVALUATOR SIGNATURE:	DATE: 02/28/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/28/2024

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: SUNNYMONT-WESTSIDE PARENT CO-OP NURSERY SCHOOL	FACILITY NUMBER: 434413020
	VISIT DATE: 02/28/2024

NARRATIVE

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Records review
Disaster drills shall be conducted at least every six months and be maintained for at least one year. The last drills were conducted on 2 / 6 / 24 . LPA reviewed facility's sign in/out procedure and record.

A sampling of children files were selected for review. Children records reviewed includes Admission Agreement, Identification and Emergency Information, Consent for Emergency Medical Treatment form, Medical Assessment, and immunization. Staff records reviewed include Criminal Record and Child Abuse Index Background Check Clearance, Health Screening Report with TB Clearance, Immunization Record for Measles and Pertussis, Education Qualification, and required Training. Verification of teaching experience from the prior employers, proof of 8 hours of preventive health & safety training with one hour nutrition and lead training, and proof of completion of the operations/record keeping orientation were not observed in the folder of the director, Prudence Kolano.

LPA advised the director that the AB1207 Mandated Reporter Training needs to be renewed every two years. There was at least one person with documented current certification in Pediatric CPR/1st Aid present at the facility during LPA' inspection. LPA advised the director that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Discussion
Water lead test: 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 pursuant to Written Directives section 101700 (PIN 21-21.1- CCP). LPA verified that the lead testing was completed on 5/23/19. LPA referred the director to the Department website for lead: Lead Toxicity Prevention and Water Testing Information. Beginning January 1, 2019 AB2370 requires licensed homes and centers to share information on the risks and effects of lead exposure with enrolling and re-enrolling families.

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SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Sheena Chin
LICENSING EVALUATOR SIGNATURE:	DATE: 02/28/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/28/2024

LIC809 (FAS) - (06/04)

Page: 3 of 5

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: SUNNYMONT-WESTSIDE PARENT CO-OP NURSERY SCHOOL	FACILITY NUMBER: 434413020
	VISIT DATE: 02/28/2024

NARRATIVE

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Incidental Medical Services (IMS): This facility provides Incidental Medical Services – IMS, but per Director, currently the facility does not have any children in care who requires IMS. 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.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of “medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication. Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-carecenters/.

Deficiency
Regulatory violations were observed during the inspection. Citations were issued.

Further questions
To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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.

Exit
Exit interview was conducted, where this report, the citation, plan of correction, and appeal rights were reviewed and discussed with Licensee, Prudence Kolano.
Notice of Site Visit was given and must remain posted for 30 days.

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Sheena Chin
LICENSING EVALUATOR SIGNATURE:	DATE: 02/28/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/28/2024

LIC809 (FAS) - (06/04)

Page: 4 of 5

Document Has Been Signed on 02/28/2024 04:52 PM - It Cannot Be Edited

Created By: Sheena Chin On 02/28/2024 at 11:48 AM

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: SUNNYMONT-WESTSIDE PARENT CO-OP NURSERY SCHOOL	FACILITY NUMBER: 434413020
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/28/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101215.1(b)

Child Care Center Director Qualifications and Duties

(b) All child care centers shall have a director. 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.The director did not have required documents, proof of Verification of teaching experience from the prior employers, proof of 8 hours of preventive health & safety training with one hour nutrition and lead training, and proof of completion of the operations/record keeping orientation, which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 03/15/2024
	Plan of Correction
1 2 3 4	The director will send LPA the aboved required documetns to qualify as a director for the facility.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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:

Gladys Kuizon

LICENSING EVALUATOR NAME:

Sheena Chin

LICENSING EVALUATOR SIGNATURE:

DATE: 02/28/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/28/2024

LIC809 (FAS) - (06/04)

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