434415727-3-8-2022-07-CC-OCAO-CCBTP8-20220308135354

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434415727
Report Date: 03/08/2022
Date Signed: 03/08/2022 01:54:02 PM

Document Has Been Signed on 03/08/2022 01:54 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:	ESTRELLA FAMILY SERVICES @ GALARZA		FACILITY NUMBER:	434415727
ADMINISTRATOR:	MICHAEL STREET		FACILITY TYPE:	850
ADDRESS:	1610 BIRD AVENUE		TELEPHONE:	(408) 287-3447
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95125
CAPACITY: 24	TOTAL ENROLLED CHILDREN: 8	CENSUS: 2	DATE:	03/08/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:55 AM
MET WITH:	Michael Street		TIME COMPLETED:	01:50 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 Analysts (LPAs) Ofelia Calivo and Samantha Yip conducted an unannounced Required – 1 Year inspection. LPAs met with Site Director Michael Street and explained the reason for the inspection. Facility requested a waiver to share the same outdoor space as the State Preschool on campus on 03/2020. However, due to COVID, facility no longer requesting a waiver. Site Director understands that they need to submit a waiver request if they want to share the same outdoor space with the State Preschool. Facility is using the yard located in Room G1. Measurements were conducted during today’s inspection. LPAs observed two preschool children and one teacher during today's inspection. Facility is located on the Ernesto Galarza Elementary School campus in Room G1. The hours of operation are Monday through Friday 9:15AM to 12:15PM. License, Emergency Disaster Plan, Menus, and Notification of Parent's Rights were posted. Facility uses electronic sign in/out. LPAs reviewed sign in/out and verified children are signed in. LPAs toured inside and outside of the facility. The room was observed to be clean. Disinfectant, cleaning supplies, and other items that are dangerous to children were observed to be stored inaccessible to children. Furniture and equipment, such as chairs and tables, were observed to be in good condition. LPAs observed sufficient amount of toys for children. Storage containers for waste have tight-fitted lids. LPAs observed restroom for children's use. LPAs observed a fully charged fire extinguisher and smoke detector. Site Director stated that there are no weapons, such as firearms, stored on the premise. There were no bodies of water observed during today's inspection. LPAs discussed with Site Director that children need to be visually supervised at all times, including when they are using the restroom.

SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Ofelia Calivo
LICENSING EVALUATOR SIGNATURE:	DATE: 03/08/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/08/2022

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: ESTRELLA FAMILY SERVICES @ GALARZA	FACILITY NUMBER: 434415727
	VISIT DATE: 03/08/2022

NARRATIVE

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The outdoor area is fenced. There are toys and equipment for children. Shaded rest area is provided through canopy and building overhang. The measurement for the outdoor area are as followed:

82.583 x 23.417 = 1933.846 + 17.500 x 21.333 = 373.327 + 23 x 45.667 = 1050.341 + ½ (37.333 x 18.833) = 351.545 = 3709.060 minus encumbered space 5 x 4.167 = 20.835 + 2 x 3.583 = 7.166 + 4.833 x 3.083= 14.900 + 4 x 3.250 = 13 + 8.250 x 6.250 = 51.562 + 2.417x4.250=10.272 = 117.735 = 3591.325

Total outdoor square footage: 3591.325 divided by 75 = 47 children

An sketch of the outdoor area was obtained during today's inspection.

Facility does provide snacks to children in care. Menu was observed to be posted. Area to prepare snacks was observed to be clean. LPAs reminded Site Director to check the expiration dates of milk and food. Drinking water is provided through water fountain, water cooler, and cups.

Site Director stated that they do not currently have any children in care who requires Incidental Medical Services (IMS). 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

2 children's files were reviewed during today's inspection. The records reviewed include but not limited to admission agreement and parent's rights.

2 staff files were reviewed during today's inspection. The records reviewed include but not limited to education credit and Mandated Reporter Training. LPAs observed that S-1 last completed the Mandated Reporter training on 12/05/2018. LPAs reminded Site Director that the Mandated Reporter Training requires renewal every 2 years. There is currently at least one staff on site with a valid CPR/1st Aid, which expires on 03/06/2023.

SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Ofelia Calivo
LICENSING EVALUATOR SIGNATURE:	DATE: 03/08/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/08/2022

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: ESTRELLA FAMILY SERVICES @ GALARZA	FACILITY NUMBER: 434415727
	VISIT DATE: 03/08/2022

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All staff present have cleared criminal record and child abuse index clearance. Site 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.

As a result of this inspection, one technical violation was issued.

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.

IA notice of site visit was given and must remain posted for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the Site Director Michael Street.

SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Ofelia Calivo
LICENSING EVALUATOR SIGNATURE:	DATE: 03/08/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/08/2022

LIC809 (FAS) - (06/04)

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