434414756-3-1-2024-07-CC-SCHN-D2XW56-20240301155837

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434414756
Report Date: 03/01/2024
Date Signed: 03/01/2024 03:58:44 PM

Document Has Been Signed on 03/01/2024 03:58 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:	SAN JOSE GRAIL FAMILY SERVICES		FACILITY NUMBER:	434414756
ADMINISTRATOR:	CARMEN LOPEZ-ALFARO		FACILITY TYPE:	850
ADDRESS:	2003 E. SAN ANTONIO STREET		TELEPHONE:	(408) 347-7892
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95116
CAPACITY: 24	TOTAL ENROLLED CHILDREN: 24	CENSUS: 16	DATE:	03/01/2024
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	12:40 PM
MET WITH:	Carmen Lopez-Alfaro		TIME COMPLETED:	04:15 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 3/1/24 Licensing Program Analyst (LPA), Sheena Chin, conducted an unannounced Required - 3 year inspection of the Preschool. LPA met with the director, Carmen Lopez-Alfaro, and explained the purpose of the visit. The Facility is licensed to serve 3 – 5 years. Ambulatory only. Hours of operation: morning session - 8:00 AM to 11:30 AM; afternoon session – 12:30PM to 4:00PM Monday to Friday. 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 did not administer any medication but this facility provides Incidental Medical Services (IMS). The director stated that the facility did not provide food but snacks. Observation LPAs toured the indoor and outdoor areas of the Facility with the director, Carmen Lopez-Alfaro. 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 fire inspection on 2/26/24. LPA observed fully charged Fire Extinguishers, functioning smoke/carbon monoxide detectors, First Aid Kit, central heating, and air conditioning in the classroom. 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. Trash cans operated by batteries for solid waste had covers on but kept the lid up due to no batteries. LPA advised the director to close the trash can for sanitation. continue to page 2.

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Sheena Chin
LICENSING EVALUATOR SIGNATURE:	DATE: 03/01/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/01/2024

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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Document Has Been Signed on 03/01/2024 03:58 PM - It Cannot Be Edited

Created By: Sheena Chin On 03/01/2024 at 03:03 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: SAN JOSE GRAIL FAMILY SERVICES	FACILITY NUMBER: 434414756
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/01/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1597.16(a)(1)

Lead Testing

(1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on interview and record review, the licensee did not comply with the section cited above. The facility did not have water tested for lead, which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 03/29/2024
	Plan of Correction
1 2 3 4	The director stated that the faciliyt was working on selecting the contractor to conduct the water lead test and would send LPA the result by the due date.

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. 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. S5 did not have the mandated reporter training certificate, which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 03/08/2024
	Plan of Correction
1 2 3 4	The director stated that she would have the S5 finish the mandated reporter training and send LPA the copy of the certificate.

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: 03/01/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/01/2024

LIC809 (FAS) - (06/04)

Page: 2 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: SAN JOSE GRAIL FAMILY SERVICES	FACILITY NUMBER: 434414756
	VISIT DATE: 03/01/2024

NARRATIVE

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Observation
The teacher/child ratio was in compliance during today's inspection. 16 children with 3 teachers and an aid in the classroom. 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 not located in the facility. Children and staff needed to pass a public entrance to the playground. Enclosed fence and gates were observed. The playground was used by both the preschool center and the other toddler facility, who had the waiver for the playground use. The director stated that she understood the regulations to use the playground. Shade is provided by a canopy in the playground area. The outdoor equipment is age-appropriate and in good condition. Rubber surfacing is used as resilient material throughout the playground. There were no bodies of water observed.

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 / 12 / 24 . LPA reviewed facility's sign in/out procedure and record. A sampling of children and staff files was 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. S5 did not have mandated reporter training. The director stated that she would have the staff finish the required document. 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's 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.

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SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Sheena Chin
LICENSING EVALUATOR SIGNATURE:	DATE: 03/01/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/01/2024

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: SAN JOSE GRAIL FAMILY SERVICES	FACILITY NUMBER: 434414756
	VISIT DATE: 03/01/2024

NARRATIVE

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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). The facility did not have water tested for lead, incompliant with regulations outlined in PIN 21-21.1.CCP. The director stated that the facility was working on selecting a contractor for the test. 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.

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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. 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) 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-care-centers/.

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

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SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Sheena Chin
LICENSING EVALUATOR SIGNATURE:	DATE: 03/01/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/01/2024

LIC809 (FAS) - (06/04)

Page: 4 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: SAN JOSE GRAIL FAMILY SERVICES	FACILITY NUMBER: 434414756
	VISIT DATE: 03/01/2024

NARRATIVE

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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, Carmen Lopez-Alfaro.
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: 03/01/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/01/2024

LIC809 (FAS) - (06/04)

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