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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434416230
Report Date: 04/26/2024
Date Signed: 04/30/2024 04:15:42 PM

Document Has Been Signed on 04/30/2024 04:15 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 CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:SJB-FOOTHILL CHILD DEVELOPMENT CENTERFACILITY NUMBER:
434416230
ADMINISTRATOR/
DIRECTOR:
ANN-MARIE LEMMERMANFACILITY TYPE:
830
ADDRESS:230 PALA AVENUETELEPHONE:
(408) 928-5223
CITY:SAN JOSESTATE: CAZIP CODE:
95127
CAPACITY: 25TOTAL ENROLLED CHILDREN: 25CENSUS: 2DATE:
04/26/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:associate program director Maria VelazquezTIME VISIT/
INSPECTION COMPLETED:
04:30 PM
NARRATIVE
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On 4/26/24 around 9:30am Licensing Program Analyst (LPA), Sheena Chin, conducted an unannounced annual inspection of the center. The director was off, and the staff contacted the associate program director, Maria Velazquez to cover the director. Around 10:02am LPA met with Ms. Velazquez and explained the purpose of the visit. The Facility is licensed to serve 9 infants ages 0 to 18 months, 16 toddlers ages 18 months to 3 years old in the infant classroom and toddler classroom. Hours of operation: 7:00 AM to 6:00 PM Monday to Friday. Ms. Velazquez stated that the facility did not have weapons on the premises, that smoking was not allowed on the premises and that the facility provided Incidental Medical Services – IMS to children in care but currently no children needed IMS.

Observation
LPAs toured the indoor and outdoor areas of the Facility with Ms. Velazquez. 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 were observed.

The facility passed fire inspection on 10/1/23. LPA observed fully charged Fire Extinguishers, functioning smoke/carbon monoxide detectors, First Aid Kit, central heating, and air conditioning in all rooms. Furniture and equipment were observed to be age appropriate and in good condition, free of sharp, loose, or pointed parts. Disinfectants, cleaning solutions, poisons, sharps, and other items that are dangerous to children were stored inaccessible. Restrooms for children to use were observed to be in operating condition. Play equipment were maintained in a good condition, free of hazards.

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SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Sheena Chin
LICENSING EVALUATOR SIGNATURE: DATE: 04/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/26/2024
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: SJB-FOOTHILL CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 434416230
VISIT DATE: 04/26/2024
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Observation
The facility provided breakfast, lunch, and snacks for toddler and fed infants on demand. Meals are prepared and packaged by the facility's "Central Kitchen," which is off site, and then delivered to the facility. Trash cans for solid waste had tight-fitting covers on.

The teacher/child ratio was in compliance during today's inspection. 2 infants with 2 teachers in the infant room. 5 toddler children with two teachers in toddler 1A room and 6 toddlers with 2 teachers in toddler room 1B. Ms. Velazquez stated that she understood the conditions, limitations, and capacity specifications of the Facility license and that children shall be always supervised within the classroom and in the playground areas.

The playground area for toddlers was surrounded by appropriate fencing. LPA observed that there were no trees or canopies for shades in the playground area. The outdoor equipment was age-appropriate and in good condition. Grass was used throughout the playground. There were no bodies of water observed.

Records review
Disaster drills shall be conducted at least every six months and be maintained for at least one year. The last drills were conducted on 4/26/24. LPA observed that the staff took the toddlers outside for the drill and infants were put in an emergency crib, rolling outside for the drill.

LPA reviewed facility's sign in/out procedure and record. A sampling of children and staff files was selected for review. Children records reviewed includes Admission Agreement, Identification and Emergency Information, Consent for Emergency Medical Treatment form, Medical Assessment, and immunization. Staff records reviewed include Criminal Record and Child Abuse Index Background Check Clearance, Health Screening Report with TB Clearance, Immunization Record for Measles and Pertussis, Education Qualification, and required Training. LPA advised Ms. Velazquez that the AB1207 Mandated Reporter Training needs to be renewed every two years. There was at least one person with documented current certification in Pediatric CPR/1st Aid present at the facility during LPA' inspection.

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SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Sheena Chin
LICENSING EVALUATOR SIGNATURE:

DATE: 04/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/26/2024
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 CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: SJB-FOOTHILL CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 434416230
VISIT DATE: 04/26/2024
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Records review
LPA advised Ms. Velazquez 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.

On 5/16/23, SJB Child Development Centers had a contractor to conduct water lead test, including this facility but no water lead test result was provided to the facility. Ms. Velazquez stated that according to the contractor the water main pipe was not in the infant center but in another center of the same building. Therefore according to the contractor it’s unnecessary for the infant center to conduct water lead test. Ms. Velazquez confirmed that SJB didn't learn the situation until now. LPA advised Ms. Velazquez that per 1597.16(a)(1) a licensed child day care center built before 1/1/2010 shall have its drinking water tested for lead contamination level. During the inspections the facility learned that the facility used the same water source with another center so the program director, Melissa Leza requested for a waiver of the water lead test for the facility.

Discussion
Water lead test: 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). All centers need to complete the lead testing in accordance to the Written Directives outlined in PIN 21-21.1.CCP. LPA referred the director to the Department website for lead: Lead Toxicity Prevention and Water Testing Information. Beginning January 1, 2019 AB2370 requires licensed homes and centers to share information on the risks and effects of lead exposure with enrolling and re-enrolling families.

Ms. Velazquez declined to sign this page due to the documentation in the 2nd paragraph.


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SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Sheena Chin
LICENSING EVALUATOR SIGNATURE:

DATE: 04/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/26/2024
LIC809 (FAS) - (06/04)
Page: 3 of 5
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: SJB-FOOTHILL CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 434416230
VISIT DATE: 04/26/2024
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Discussion
Incidental Medical Services (IMS): This facility provides Incidental Medical Services – IMS, but per Director, currently the facility does not have any children in care who requires IMS. 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.

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. 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/.

Deficiency
The facility failed to provide a water lead test report. A Citation was issued.

Further questions
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.

Exit
Exit interview was conducted, where this report, the citation, plan of correction, and appeal rights were reviewed and discussed with the associate program director, Maria Velazquez.
Notice of Site Visit was given and must remain posted for 30 days.

Ms. Velazquez declined to sign due to the violation.
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Sheena Chin
LICENSING EVALUATOR SIGNATURE:

DATE: 04/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/26/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 04/30/2024 04:15 PM - It Cannot Be Edited


Created By: Sheena Chin On 04/26/2024 at 02:46 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: SJB-FOOTHILL CHILD DEVELOPMENT CENTER

FACILITY NUMBER: 434416230

DEFICIENCY INFORMATION FOR THIS PAGE:

VISIT DATE: 04/26/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Deficiency Dismissed
Type B
Section Cited
HSC
1597.16(a)(1)
Lead Testing
(1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above. The facility did not have the water lead test result, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/03/2024
Plan of Correction
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During the inspections the program director, Melissa Leza submited the request for water lead test waiver.
Ms. Velazquez declined to sign this page.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Gladys Kuizon
LICENSING EVALUATOR NAME:Sheena Chin
LICENSING EVALUATOR SIGNATURE:
DATE: 04/26/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/26/2024


LIC809 (FAS) - (06/04)
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