434416231-4-30-2024-07-CC-SCHN-D4TVAW-20240430161636

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434416231
Report Date: 04/26/2024
Date Signed: 04/30/2024 04:16:47 PM

Document Has Been Signed on 04/30/2024 04:16 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 CENTER		FACILITY NUMBER:	434416231
ADMINISTRATOR/ DIRECTOR:	ANN-MARIE LEMMERMAN		FACILITY TYPE:	850
ADDRESS:	230 PALA AVENUE		TELEPHONE:	(408) 928-5223
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95127
CAPACITY: 15	TOTAL ENROLLED CHILDREN: 15	CENSUS: 16	DATE:	04/26/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:30 AM
MET WITH:	assoicate program director Maria Velazquez		TIME VISIT/ INSPECTION COMPLETED:	04:00 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	Page 1. 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 15 preschoolers ages 3 years until entry into first grade in the preschool class room. 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. continue to page 2.

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)

Page: 1 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: 434416231
	VISIT DATE: 04/26/2024

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
26
27
28
29
30
31
32

Page 2.

Observation
The facility provided breakfast, lunch, and snacks. 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. 16 children were with 3 teachers in the classroom. The licensed capacity for the preschool was 15. LPA advised Ms. Velazquez 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 preschoolers was surrounded by appropriate fencing. Shade was provided by trees and a canopy in the playground area. The outdoor equipment was age-appropriate and in good condition. There was a climbing structure in the playground that was age appropriate. Rubber surfacing was used as resilient material throughout the playground. Areas around and under high climbing equipment were cushioned with material that absorbs falls. 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 16 preschool children 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.

continue to page 3.

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: 2 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: 434416231
	VISIT DATE: 04/26/2024

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
26
27
28
29
30
31
32

Page 3.

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 9/18/23, the facility had water lead test, ND of ppb.

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.

LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1.CCP.

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.

continue to page 4.

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: 434416231
	VISIT DATE: 04/26/2024

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
26
27
28
29
30
31
32

Page 4.

Discussion
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
Regulatory violation was observed, and 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.

LPA advised the director to print out this licensing report and deficiency report for parents to review and have parents sign LIC 9224 form. LPA advised the director that a copy of this report shall be provided to parent/guardian of any newly enrolled children for the next 12 months. LPA advised the director to post this report and the Notice of Site Visit for 30 days. Failure to maintain postings as required will result in an immediate $100 civil penalty.

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: 4 of 5

Document Has Been Signed on 04/30/2024 04:16 PM - It Cannot Be Edited

Created By: Sheena Chin On 04/26/2024 at 01:58 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: 434416231
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 04/26/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type A

Section Cited

CCR

101161(a)

Limitations on Capacity and Ambulatory Status

(a) A licensee shall not operate a child care center beyond the conditions and limitations specified on the license, including the capacity limitation. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, interview and record review, the licensee did not comply with the section cited above. 16 children were with 3 teachers in the classroom. The licensed capacity for the preschool was 15, which poses an immediate health, safety or personal rights risk to persons in care.
	POC Due Date: 04/29/2024
	Plan of Correction
1 2 3 4	The program director, Melissa Leza stated that the facility will work with family services to remove one child and will notify LPA the result. Ms. Leza stated that the facility will submit a statement to the licensing department about how to prevent over capacity from happening again.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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)

Page: 5 of 5