434414756-3-13-2025-07-CC-LHUG-DEQQAU-20250313120030

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434414756
Report Date: 03/12/2025
Date Signed: 03/13/2025 12:00:53 PM

Document Has Been Signed on 03/13/2025 12:00 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/ DIRECTOR:	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: 19	DATE:	03/12/2025
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	12:20 PM
MET WITH:	Carmen Lopez-Alfaro		TIME VISIT/ INSPECTION COMPLETED:	03:40 PM

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Licensing Program Analysts (LPAs) Kate Huang and Anna Morales met with Director Carmen Lopez-Alfaro for an unannounced Annual Required Inspection. The purpose of today’s inspection was explained to the Director. The facility's License, Notification of Parents’ Rights Poster, Child Car Seat Law, Personal Rights (LIC 613A), Emergency Disaster Plan, Menus, Activity Schedule, and Earthquake Preparedness Checklist were observed posted near the entrance. The center’s operating hours are Monday through Friday: morning session from 8:00 AM to 11:30 AM, and afternoon session from 12:30 PM to 4:00 PM. The teacher-to-child ratio was in compliance during today’s inspection, with 19 children, and 3 fully qualified teachers present in the classroom.

The indoor and outdoor areas were toured during today's inspection with director. LPAs 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. LPAs did not observe any disinfectants, cleaning solutions, poisons, sharps, and other items that are dangerous to children were accessible to children. Restrooms for children and staff to use were observed to be in good operating condition. LPA observed trash cans with tight fitting lids for the disposal of solid waste throughout the Facility. LPAs inspected the kitchen of the center, which is kept clean and free of litter and rubbish. Director stated that they do not provide lunch for children, but they provide snack, fruit and milk.

The playground area used by children is surrounded by fencing. Shade is provided by canopies. LPAs observed that the outdoor equipment is age-appropriate and in good condition. No bodies of water were observed. The playground is shared by both the preschool center and the other toddler facility, which holds a waiver for its use. Rubber surfacing is used as the resilient material throughout the playground.

LPAs reviewed sign in and out record, and procedure. LPAs checked the documentations for fire/earthquake drills. The center conducted fire/earthquake drills once a month and the last drill was conducted on 03/07/25.

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Linke Huang
LICENSING EVALUATOR SIGNATURE:	DATE: 03/12/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2025

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: SAN JOSE GRAIL FAMILY SERVICES	FACILITY NUMBER: 434414756
	VISIT DATE: 03/12/2025

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LPAs reviewed five children's files during today's inspection. Children records reviewed include Admission Agreement, Identification and Emergency Information, Consent for Emergency Medical Treatment, Notification of Parent Rights, Personal Rights Notice, Physician's Report, Medical Assessment, and Immunization records.

LPA reviewed three staff files during today's inspection. Staff records reviewed include: Personnel Record, Employee Rights, Statement Acknowledging Requirement to Report Child Abuse, Health Screening Report with TB Clearance, Immunization records (Measles, Pertussis, and Influenza), proof of education qualification, valid mandated reporter training certificates. Three of the staff reviewed have current Pediatric CPR/First Aid certifications on file.

Director was reminded 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.

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).

LPAs verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1.CCP. The center conducted a lead test in March 2024.

LPAs referred Director to the Department website for lead: Lead Toxicity Prevention and Water Testing Information.

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Linke Huang
LICENSING EVALUATOR SIGNATURE:	DATE: 03/12/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2025

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: SAN JOSE GRAIL FAMILY SERVICES	FACILITY NUMBER: 434414756
	VISIT DATE: 03/12/2025

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LPAs also informed Director 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.

This facility provides Incidental Medical Services – IMS. LPAs reviewed storage of “medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. Only one child requires medication, accompanied by doctor's notes and parental consent. 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/.

Director was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

No deficiencies cited during today's visit. A notice of site visit was given and must remain posted for 30 days.

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 interview was conducted and report was reviewed with the Director, Carmen Lopez-Alfaro.

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Linke Huang
LICENSING EVALUATOR SIGNATURE:	DATE: 03/12/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2025

LIC809 (FAS) - (06/04)

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