434415408-9-20-2024-07-CC-MSMS-D9APTC-20240920113544

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434415408
Report Date: 09/20/2024
Date Signed: 09/20/2024 11:35:48 AM

Document Has Been Signed on 09/20/2024 11:35 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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME:	HILLSIDE CHRISTIAN PRESCHOOL		FACILITY NUMBER:	434415408
ADMINISTRATOR/ DIRECTOR:	MARLENE ALLEN		FACILITY TYPE:	850
ADDRESS:	545 HILLSDALE AVENUE		TELEPHONE:	(408) 269-1995
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95136
CAPACITY: 60	TOTAL ENROLLED CHILDREN: 52	CENSUS: 20	DATE:	09/20/2024
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	08:30 AM
MET WITH:	Dawn Escobedo		TIME VISIT/ INSPECTION COMPLETED:	12:00 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) Mel Matos met with Dawn Escobedo, Director, for an unannounced Required - 3 year inspection. LPA notes that the Facility is located on the premises of Hillside Church and parking is available in the Church parking lot. LPA toured the indoor and outdoor areas of the Facility with the Director during today's inspection. 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. Days and hours of operation are Monday through Friday 8:15 AM to 2:30 PM from September to May (school year) and 9 AM to 12:30 PM from June to July. The Facility is closed in August of each year for summer break. The Facility is licensed to serve a maximum of sixty (60) children ages two to six years in Rooms 205, 207, 209, and 210. The Facility has one active waiver on file (playground space) and is in compliance with the conditions of the waiver. LPA reviewed six children's and eight staff files (1 director, 5 teachers, and 2 aides) during today's inspection. Each child's file reviewed contains the required documents; including the Information and Emergency Information form (LIC 700) and immunization records. All staff files reviewed contain the required documents; including 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. Last fire/disaster drill was completed on September 10, 2024. All staff have current CPR and First Aid certifications on file. Dawn 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). LPA observed that the teacher/child ratio was in compliance during today's inspection. LPA observed one preschool child with one teacher in Room 205, six preschool children with two teachers in Room 207, eight preschool children with one teacher & one aide in Room 209, and five preschool children with one teacher & one aide in Room 210 during today's inspection. Director understands the conditions, limitations, and capacity specifications of the Facility license. Dawn understands that children shall be visually supervised at all times. Any child(ren) who exhibit symptoms of illness including, but not limited to, fever or vomiting, are not accepted in care. Any child(ren) who become ill during the day, shall be isolated in the director’s office area. LPA observed that the Facility is clean, safe, sanitary, and in good repair for children, staff, and visitors. The Facility has adequate ventilation, including central air conditioning/heating. Dawn states that a private cleaning service as well as Church Staff clean the Facility Monday through Friday in the evenings. Dawn understands that the Facility must be kept free of flies and other insects & rodents. LPA observed that all furniture and equipment is in good condition and safe for the children.

SUPERVISORS NAME: Belinda Devall
LICENSING EVALUATOR NAME: Melvin S Matos
LICENSING EVALUATOR SIGNATURE:	DATE: 09/20/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2024

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 CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: HILLSIDE CHRISTIAN PRESCHOOL	FACILITY NUMBER: 434415408
	VISIT DATE: 09/20/2024

NARRATIVE

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Drinking water is readily available for the children in the Facility via reusable water bottles/filtered water source. Staff and children's bathrooms are clean, sanitary, and operable. There is a separate staff bathroom not utilized by the children which an isolated child can use if needed. Director states that there are no weapons or firearms on the premises. The Facility has functioning carbon monoxide detectors in the Facility.

The food preparation and storage areas are clean, free of litter & rubbish, and free of rodents and other vermin. All food and beverages that require refrigeration are stored in covered containers at 45 degrees F or less. The Facility provides snacks to the children and parents provide lunches for the children. The Facility has trash cans with tight fitting lids for solid waste. Cleaning supplies are inaccessible to the children and stored in high cabinets inaccessible to children. Dawn states that there are no poisons in the Facility. LPA observed a complete First Aid kit in the Facility. Dawn understands that smoking is not allowed on the Facility premises.

Director states that the Facility does not administer any medications at this time. 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

The preschool playground is surrounded by appropriate fencing and the outdoor surfaces are safe for children. The playground equipment is age appropriate and artificial grass with wood chips is used as resilient material. Shade is provided by the sun sails and trees. Drinking water is available via reusable water bottles/filtered water source. There is adequate age appropriate supplies and toys for children in the playground. LPA did not observe any bodies of water during today's inspection. Director states that the Facility does not provide transportation.

Dawn Escobedo, Director, 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.

Dawn Escobedo, 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.

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.
Exit interview conducted and report was reviewed with the Director, Dawn Escobedo. A notice of site visit was given and must remain posted for 30 days.

SUPERVISORS NAME: Belinda Devall
LICENSING EVALUATOR NAME: Melvin S Matos
LICENSING EVALUATOR SIGNATURE:	DATE: 09/20/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2024

LIC809 (FAS) - (06/04)

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