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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434416175
Report Date: 10/14/2021
Date Signed: 11/02/2021 03:51:16 PM

Document Has Been Signed on 11/02/2021 03:51 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:SJB - JAMES LICK CHILD DEVELOPMENT CENTERFACILITY NUMBER:
434416175
ADMINISTRATOR:LINDSAY MASUDAFACILITY TYPE:
850
ADDRESS:57 NORTH WHITE ROADTELEPHONE:
(408) 928-5221
CITY:SAN JOSESTATE: CAZIP CODE:
95127
CAPACITY: 36TOTAL ENROLLED CHILDREN: 36CENSUS: DATE:
10/14/2021
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Patricia Keith TIME COMPLETED:
02:44 PM
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Pp1
Licensing Program Analysts (LPA),Stephanie Collins, met with Site Director, Patricia Keith and Rebecca Larsen and explained the purpose of the inspection the licensee submitted an application for an increase in capacity in the preschool’s activity area. The preschool will be expanding their creative curriculum to include a Culinary Learning Center for Preschool only . Culinary Center activities will take place in the kitchen area of the classroom. Culinary activity will take place prior to or after the daily lunch and snack preparation by staff . All cabinets doors, drawer, stove and refrigerators have locks or child safety locks in place to ensure the children’s safety. All culinary activities will be instructed and supervised by facility staff. Indoor measurements are as follows:

PRESCHOOL ROOM:
35.000 x 31.333 = 1,114.155 minus 325.344 (encumbered space)
= 788.81 (Per measurements 06/26/2019)
21.58 x 10.58
= 228.32
Toddler Room/Area
29.833 x 24.500 =730.908 minus 215.064 (encumbered space)
= 515.844 (Per measurements 06/26/2019)

TOTAL PRESCHOOL INDOOR SPACE: 788.81 sq. ft. + 228.32 sq. ft. + 515.844 sq.ft. = 1,532.974 sq. ft. divided by 35 = 43 children.

There are 3 sinks (45) and 2 toilets (30) available for the children in the preschool program.
and 3 sinks (45) and 2 toilets (30) available for the children in the reserved for the toddler component.
SUPERVISORS NAME: Sandy Knight
LICENSING EVALUATOR NAME: Stephanie Collins
LICENSING EVALUATOR SIGNATURE: DATE: 11/02/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/02/2021
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: SJB - JAMES LICK CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 434416175
VISIT DATE: 10/14/2021
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The kitchen is located in between Preschool and Toddler Room. The kitchen is equipped with refrigerators, oven, stove, microwave, dishwasher, and a sink with hot and cold running water. Disposable dishes and utensils will be available for the children. Sanitation is by the dishwasher. LPA observed trash cans with tight-fitting lids in each room for the disposal of solid waste. Cleaning products, sharp, objects, and other similar items are stored in the upper cabinet in the classroom. LPA observed at least one functioning carbon monoxide detector at the facility. Site Director states there are no weapons on the premises. Drinking water indoor for preschool and toddler option children is via water fountains. Fire inspection granted 9/10/2021

PRESCHOOL OUTDOOR MEASUREMENTS: (Per 06/26/2021 Report)
PRESCHOOL YARD: 31.500 x 19.417 = 611.63
18.750 x 13.583 = 254.681
14.250 x 13.500 = 192.375
53.583 x 46.250 = 2,478.213
37.000 x 19.083 = 706.071
4,242.97 minus 191.048
TOTAL PRESCHOOL OUTDOOR SPACE: 4,051.922 sq ft divided by 75 = 54 children

LPA discussed Senate Bill 792, Assembly Bill (AB) 1207 (Mandated Child Abuse Reporter Training) which is required training that began on January 1, 2018 and requires renewal every two years. AB 633 was discussed with Site Director. Licensing forms, Title 22 regulations, can be obtained through the internet at www.ccld.ca.gov. Mandated Reported Training can be accessed at http://www.mandatedreporterca.com/www.mandatedreporterca.com. LPA provided Site Director with lead safety information sheets and advised her to provide copies to parents.

A license for 24 preschool children will be approved pending management's review and final approval and the receipt of the following:
SUPERVISORS NAME: Sandy Knight
LICENSING EVALUATOR NAME: Stephanie Collins
LICENSING EVALUATOR SIGNATURE:

DATE: 10/14/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/14/2021
LIC809 (FAS) - (06/04)
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