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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434415126
Report Date: 02/23/2024
Date Signed: 02/23/2024 11:47:55 AM

Document Has Been Signed on 02/23/2024 11:47 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:PRECIOUS MOMENTS PRESCHOOLFACILITY NUMBER:
434415126
ADMINISTRATOR:PRIYANKA BANSALFACILITY TYPE:
850
ADDRESS:330 SOUTH MONROE STREETTELEPHONE:
(408) 320-2149
CITY:SAN JOSESTATE: CAZIP CODE:
95128
CAPACITY: 36TOTAL ENROLLED CHILDREN: 38CENSUS: 27DATE:
02/23/2024
TYPE OF VISIT:Annual/RequiredUNANNOUNCEDTIME BEGAN:
08:50 AM
MET WITH:Priyanka BansalTIME COMPLETED:
12:00 PM
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Licensing Program Analyst (LPA) Marilou Monico met with Site Director, Priyanka Bansal, for an unannounced Annual Required Inspection. The purpose of today's inspection was explained with Priyanka. Facility's License, Notification of Parents’ Right Poster, Child Car Seat Law, Personal Rights (LIC 613A), Emergency Disaster Plan, Menus, Activity Schedule, and Earthquake Preparedness Checklist were observed to be posted. The facility has no active waivers. The center's operating hours are Monday through Friday from 08:15 AM to 5:30 PM. The facility is licensed to serve children ages 2 years to 6 years old in Rooms 1,2,3 and entryway/play area.

LPA toured the indoor and outdoor areas. LPA observed that the teacher-child ratio was in compliance. Fire drill was conducted on January 10, 2024. The facility has current children's roster and a copy was provided to LPA during the inspection. Cleaning products, disinfectants, sharp objects were stored inaccessible to children. Furniture and equipment were observed to be age appropriate and in good condition. The facility is clean. The bathrooms for children and staff are clean, sanitary, and operable. LPA observed 3 toilets and 3 sinks available for the children. Site Director stated that the facility has a third party cleaning service that comes every day after daycare hours to clean.

The center provides breakfast and lunch to the children. There is a food preparation area in Room 1. The food preparation area is equipped with microwave, toaster, instant pot, and a sink with hot and cold running water. Drinking water is available for the children indoor via drinking fountains and individual water bottles. LPA observed trash cans with tight fitting covers for the disposable of solid waste. The facility has fire extinguisher and working smoke and carbon monoxide detectors.

The playground is surrounded with appropriate fencing and the outdoor surfaces are safe. Shade is provided by trees and canopy. Drinking water is readily available for the children outdoor via individual water bottles. LPA observed climbing structure with resilient material (rubber foam) under and around the structure. There were no bodies of water observed. Priyanka stated that there are no weapons or firearms on the premises.
Continuation on next pages:
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Marilou Monico
LICENSING EVALUATOR SIGNATURE: DATE: 02/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/23/2024
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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: PRECIOUS MOMENTS PRESCHOOL
FACILITY NUMBER: 434415126
VISIT DATE: 02/23/2024
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LPA reviewed 6 random children's files. Children records reviewed include Admission Agreement, Identification and Emergency Information, Consent for Emergency Medical Treatment, Physician's Report, TB test, Immunizations, Parent Right's Receipt, Personal Rights, and Health History.

LPA reviewed 5 staff files. Staff records reviewed include Employee Rights, Statement Acknowledging Requirement to Report Child Abuse, Health Screening Report with TB Clearance, Immunizations (Measles, Pertussis, and Influenza) and required training. LPA reminded Site Director that the Mandated Reporter Training shall be renewed by all staff every two years. At least one staff member present during the inspection has current Pediatric CPR/First Aid certifications.

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 Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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/resources/child-care-centers/.

Site Director, Priyanka Bansal, 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.

LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

Site Director, Priyanka Bansal, 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&R's) throughout California.



Continuation on next page:
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Marilou Monico
LICENSING EVALUATOR SIGNATURE:

DATE: 02/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2024
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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: PRECIOUS MOMENTS PRESCHOOL
FACILITY NUMBER: 434415126
VISIT DATE: 02/23/2024
NARRATIVE
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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/process.

As a result of this inspection, there were no deficiencies cited.

Exit interview conducted and report was reviewed with Site Director, Priyanka Bansal.

A NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 DAYS.
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Marilou Monico
LICENSING EVALUATOR SIGNATURE:

DATE: 02/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2024
LIC809 (FAS) - (06/04)
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