434415210-12-14-2021-07-CC-OCAO-C9PV62-20211214150848

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434415210
Report Date: 12/14/2021
Date Signed: 12/14/2021 03:08:56 PM

Document Has Been Signed on 12/14/2021 03:08 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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME:	RIVER GLEN PRESCHOOL		FACILITY NUMBER:	434415210
ADMINISTRATOR:	CLAUDIA PATERSON		FACILITY TYPE:	850
ADDRESS:	1088 BROADWAY AVENUE		TELEPHONE:	(408) 535-6083
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95125
CAPACITY: 24	TOTAL ENROLLED CHILDREN: 24	CENSUS: 9	DATE:	12/14/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:20 AM
MET WITH:	Justina Gonzalez		TIME COMPLETED:	03:20 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	Licensing Program Analyst (LPA) Ofelia Calivo met with Justina Gonzalez, Head Teacher, for an unannounced Required 1-year inspection. The Preschool program has two 3 hours session from 8:00 AM to 11:00 AM and 12:00 PM to 3:00 PM. Center will provide breakfast for the morning session and lunch is provided for the afternoon session. Individual container prepared at the school's cafeteria. No food preparation done at the center. Facility has trash can with tight fitting lid and in good condition. There are adequate tables, chairs, equipment, supplies and toys for children. Drinking water will be provided indoor and outdoor and children also bring their own bottled water from home. The working telephone number on site is (408) 535-6083. The program is operated by the San Jose Unified School District and all criminal background checks for staff are handled by the Department of Education and thus do not come under the jurisdiction of Community Care Licensing Division. LPA toured the facility both indoor and outdoor areas during today's inspection. There are 1 toilet (15) and 2 sinks (30) available for the children inside the classroom. Additional 2 toilets are in the elementary school. A waiver to share the elementary school's bathroom is on file. Cold water is available in the children's faucet. Staff have their own bathroom which is located in the school cafeteria. The sick child will be isolated in the Site Supervisor's office and isolation equipment is provided. The sick child will utilize the staff bathroom. LPA observed a working carbon monoxide detector and a smoke detector, and no fireplaces or wall heaters at the facility. The room has appropriate lighting, cooling and heating system. Medications are stored in lock boxes in the high shelves, inaccessible to children. First aid and cleaning supplies are stored in the high shelves. There are no climbing structures in the children's playground. Justina stated that trikes, hoops, balls, balance beams, building blocks are already in the warehouse and will be provided to the children to play. Shade is provided by trees and building overhangs. LPA observed no bodies of water. Per Justina, no firearms in the premises. No transportation will be provided by the school. LPA 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), Menus, and Activity Schedule.

SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Ofelia Calivo
LICENSING EVALUATOR SIGNATURE:	DATE: 12/14/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2021

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: RIVER GLEN PRESCHOOL	FACILITY NUMBER: 434415210
	VISIT DATE: 12/14/2021

NARRATIVE

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A review of staff records on December 14, 2021 indicates that all Facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. LPA reminded Justina of the applicable civil penalties for those adults who have not received fingerprint clearances, are not associated to the license and who come in contact with or provide care and supervision to the children. Penalty amounts: $100.00 per person per day, minimum of $100.00 to a maximum of $500.00 per person for an initial violation and a minimum of $100.00 to a maximum of $3000.00 per person for any subsequent violations within a 12-month period.

LPA reviewed nine children's and three staff files (1 Head Teacher & 2 Teacher Aides) during today's inspection. Each child's file reviewed contains the Information and Emergency Information form (LIC 700). All staff files reviewed contain the required transcripts/verification of experience/immunization records and Health Screening Report. All staff have current certificates of completion of the Mandated Reporter Training for Child Care Workers on file. There is at least one staff in the Facility with current CPR and First Aid certifications on file. Justina 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).

Justina understands that the Facility must be in compliance with teacher/child ratio at all times. Justina also understands the conditions, limitations, and capacity specifications of the Facility license. Justina understands that children shall be visually supervised at all times. There were nine preschool children present during today's inspection. Justina is aware of the required sign in and sign out procedures for preschool children who arrive with parents. Justina states that all preschool children are picked up by their parent(s)/guardian(s) and no children are allowed to leave the Facility on their own.

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.

Head Teacher 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.

Exit interview conducted and report was reviewed with the Head Teacher Justina Gonzalez. No deficiencies were cited 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: Ofelia Calivo
LICENSING EVALUATOR SIGNATURE:	DATE: 12/14/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2021

LIC809 (FAS) - (06/04)

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