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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434415370
Report Date: 09/10/2024
Date Signed: 09/10/2024 04:17:40 PM

Document Has Been Signed on 09/10/2024 04:17 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-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:KCE CHAMPIONS LLC @ LEDESMA ELEMENTARY - PSFACILITY NUMBER:
434415370
ADMINISTRATOR/
DIRECTOR:		ILSE RICHTERFACILITY TYPE:
850
ADDRESS:1001 SCHOOLHOUSE ROADTELEPHONE:
(408) 807-7157
CITY:SAN JOSESTATE: CAZIP CODE:
95138
CAPACITY: 24TOTAL ENROLLED CHILDREN: 11CENSUS: 9DATE:
09/10/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:44 AM
MET WITH:Ilse RichterTIME VISIT/
INSPECTION COMPLETED:
11:20 AM
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On 09/10/2024 at 8:44am, Licensing Program Analyst (LPA), Farida Raja conducted an unannounced annual/random inspection in the preschool program and met with Director, Ilse Richter. LPA explained the purpose of today’s inspection. The facility is licensed to serve 24 children ages 3-5 years in two portable classrooms located on the Ledesma Elementary School campus. LPA observed the required posted materials including menus. Days and hours of operation are Monday through Friday, 8:45 AM to 12:00 PM. The two portable classrooms are used for the Preschool Program until 12 PM and the same two classrooms are used for the School Age Program from 1:30 PM -5:30 PM.

LPA toured the indoor and outdoor areas of the preschool program during today's inspection. LPA observed 9 children and 2 teachers. Facility is in compliance with teacher to children ratio requirements.

Classrooms, children's restrooms and kitchen/storage area were inspected. There is a working telephone at the facility. Disinfectants, cleaning solutions or chemicals that are dangerous to the health and safety of children were stored under sink in a closed room and are inaccessible to children. Furniture and equipment were age appropriate and in good condition, free of sharp, loose, or pointed parts. Restrooms for children were observed to be in safe, sanitary, and operating condition. Floors were clean and free from tripping hazards. Drinking water is readily available for children in each room and in the outdoor playground area via individual water bottles and refilled from the kitchen sink. Since the preschool program is a half day program children do not nap at this facility. Director states that there are no weapons or firearms on the premises. Sick children use the bathroom in the other classroom. Staff use elementary school restrooms.

LPA observed 2 fire extinguishers and fire pull stations. The facility has built in smoke detector/ fire system. Log shows that the last Fire Drill was conducted on 09/10/2024 which is compliant with the six-month requirement for facilities.

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SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Farida Raja
LICENSING EVALUATOR SIGNATURE: DATE: 09/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/10/2024
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-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: KCE CHAMPIONS LLC @ LEDESMA ELEMENTARY - PS
FACILITY NUMBER: 434415370
VISIT DATE: 09/10/2024
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Foods and beverages were stored safely in the kitchen area. Food storage and preparation areas were observed to be sanitary. All food and beverages that require refrigeration were stored in covered containers. The facility offers morning snack for the half day preschool program. All snacks were observed to be kept in labelled containers. Medications were observed to be stored in the kitchen area in high cabinets and inaccessible to children.

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 in accordance to the Written Directives outlined in PIN 21-21.1-CCP. Water lead testing was completed by the facility on December 10, 2022. LPA provided Director with the Water Lead Report from the California State Water Resources Control Board during today's inspection. LPA observed that the indoor drinking water fountain (F) with the Action Level Exceedance is not being used to provide water to children. LPA observed water fountain is covered and signage placed stating do no use. LPA advised Director to remove water fountain fixture or stop supply of water to the fountain.

Outdoor playground for the preschool children is a gated playground located across the elementary school campus from the preschool portables. Preschool program children use the kindergarten playground. Playground and play equipment was inspected and observed to be free of hazards. LPA observed play equipment was in good condition, age-appropriate, and has sufficient resilient materials to absorb falls. Shade is provided by building overhang. There were no bodies of water observed.



Children sign in and out procedures and logs were reviewed. Children's Roster was reviewed and a copy was provided to LPA. A sampling of 6 children's files and 1 staff file were reviewed. All children's and staff files were complete with all required documentation.

Staff file reviewed contain the required transcripts/verification of experience. At least one staff member on site has a current CPR and First Aid certification on file. Director 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). Staff has the required Immunization's against pertussis, measles and influenza declination letter.

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SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Farida Raja
LICENSING EVALUATOR SIGNATURE:

DATE: 09/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2024
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-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: KCE CHAMPIONS LLC @ LEDESMA ELEMENTARY - PS
FACILITY NUMBER: 434415370
VISIT DATE: 09/10/2024
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Staff has current Mandated Reporter Training 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.

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. Director will submit an Incidental Medical Plan to the Department by 09/24/2024. Director stated that facility does handle medications but currently has no children in care who require medications or IMS. Isolation of sick child was discussed, and Director explained that sick children will be is either isolated in a separate classroom and isolation equipment will be provided. Child is always under visual supervision while in care of the facility. 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/.

Facility does not provide transportation to children, but Director understands that children cannot be left alone, unattended in parked vehicles. 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.

As a result of today's inspection, there were no deficiencies cited. Exit interview conducted and report was reviewed with the Site Director, Ilse Richter.



A NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 CONSECUTIVE 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

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Farida Raja
LICENSING EVALUATOR SIGNATURE:

DATE: 09/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2024
LIC809 (FAS) - (06/04)
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