434416249-5-15-2024-07-CC-FRAA-D5AKC8-20240515074644

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434416249
Report Date: 05/14/2024
Date Signed: 05/15/2024 07:46:51 AM

Document Has Been Signed on 05/15/2024 07:46 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-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME:	PRIMROSE SCHOOL OF EVERGREEN		FACILITY NUMBER:	434416249
ADMINISTRATOR/ DIRECTOR:	GERANNY NATIVIDAD		FACILITY TYPE:	830
ADDRESS:	3008 ABORN ROAD		TELEPHONE:	(408) 440-8215
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95135
CAPACITY: 36	TOTAL ENROLLED CHILDREN: 36	CENSUS: 30	DATE:	05/14/2024
TYPE OF VISIT:	Annual/Required	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	08:55 AM
MET WITH:	Geranny Natividad		TIME VISIT/ INSPECTION COMPLETED:	01:30 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	On 05/14/2024 at 8:55am, Licensing Program Analyst (LPA) Farida Raja conducted an unannounced annual inspection in the Infant with Toddler Component Program. LPA met with Director, Geranny Natividad, Assistant Director, Anna Yin and Owners, Mohit and Bejal Patel and explained the purpose of the today's visit. The facility is licensed to serve children ages 6 weeks to 36 months in four rooms. Preschool license (#434416248), and school age license (#434416250) are on the same premises. LPA observed the required posted materials in the facility lobby and Emergency Disaster Plans in each classroom. Days and hours of operation are Monday through Friday, 8:00 am to 6:00pm. LPA toured the indoor and outdoor areas of the Infant Program with Director, Geranny Natividad and observed the following ratios: Infant 1 (6 weeks to 12 months): 3 Teachers and 7 Infants. Infant 2 (10 -13 months): 2 Teachers and 6 Infants. Toddler 1 (12-24 months): 2 Teachers and 7 children. Toddler 2 (15-24 months): 3 Teachers and 10 children. Facility was in compliance with teacher to children ratio requirement. Classrooms, staff restrooms, kitchen and office area were inspected. Children were engaged in free play or circle time under the visual supervision of teachers. Facility has central heating/cooling for comfort of children. Director states that there are no weapons or firearms on the premises. There is a working telephone at the facility (408-440-8215). Disinfectants, cleaning products and first aid supplies were stored inaccessible to the children in care. All cabinets and drawers used for storage were locked. Continued on Page 2

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Farida Raja
LICENSING EVALUATOR SIGNATURE:	DATE: 05/14/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2024

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 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: PRIMROSE SCHOOL OF EVERGREEN	FACILITY NUMBER: 434416249
	VISIT DATE: 05/14/2024

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

Equipment and furniture including feeding chairs and cribs were age appropriate and in good condition, free of sharp, loose, or pointed parts. LPA observed solid waste containers with tight-fitting lids in the rooms. LPA observed appropriate changing tables that have raised sides (3 inches in height) and have vinyl changing pads that are at least 1 inch thick. LPA observed a trash can with tight fitting cover for the disposal of diapers that are placed under a locked cabinet under the diaper changing table. Napping equipment (mats/cribs) are appropriate. Restrooms and sinks for children were observed to be safe, sanitary, and in working condition. Staff has two separate bathrooms.

LPA observed fire extinguishers, working smoke and carbon monoxide detectors, and fire pull stations. The facility has a built-in smoke detector/ fire system. Log shows that the last Fire Drill was conducted on 02/03/2024 which is compliant with the six-month requirement for facilities. Facility does not provide transportation to children.

Drinking water is readily available for children in each room and in the outdoor playground area individual sippy cups/water bottles and refilled using a water pitcher. Water pitchers/coolers are used to refill bottles in the outdoor area. Water lead testing was completed for the facility on 04/28/2024 and no Action Level Exceedances were reported.

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). LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP. LPA provided Director with the Water Lead Report from the California State Water Resources Control Board during today's inspection.

Facility provides meals and snacks to the children in care. Menu was observed to be posted. The facility provides lunch and three snacks throughout the day for children one year of age and older. Food and beverages were stored safely to prevent contamination and spoilage. Food storage and preparation areas in classrooms and kitchen area were observed to be sanitary.

Continued on Page 3

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Farida Raja
LICENSING EVALUATOR SIGNATURE:	DATE: 05/14/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2024

LIC809 (FAS) - (06/04)

Page: 2 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: PRIMROSE SCHOOL OF EVERGREEN	FACILITY NUMBER: 434416249
	VISIT DATE: 05/14/2024

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

All food and beverages that require refrigeration are stored in covered containers. Infants bottles and food were observed to be labelled and properly stored in labelled bins. Director stated that all staff are aware of food allergies or dietary restrictions, which were observed posted in each classroom and in the kitchen. Director stated that they use the Procare app to update parents in real time regarding their child's day including diaper changes, meals, snacks and naps.

The outdoor area of the facility was inspected and observed to be fenced in. Playground and play equipment were inspected and observed to be age appropriate and free of hazards. There are adequate equipment, supplies, and toys for children outdoors. The entire outdoor area for infants and toddlers is cushioned with artificial grass to absorb falls and rubber mats are present under swings. Shade is provided by canopies. There were no bodies of water observed.

Children sign in and out procedures and logs were reviewed. Children's Roster was reviewed, and a copy was provided to the LPA. Eight (8) children's files were reviewed during today's inspection. All children's files were complete with all required documentation including needs and services plans. Facility was in compliance with the Safe Sleep regulations/requirements, including the Infant Sleeping Plan (LIC 9227) and 15 minute checks and logs.

LPA discussed the safe sleep regulations with Director and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed Director of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Six (6) staff files were reviewed. All staff maintain valid background clearances. A review of staff records indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. All staff files reviewed contain the required transcripts/verification of experience. At least one staff member on site has a current CPR and First Aid certification. Director 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).

Continued on Page 4

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Farida Raja
LICENSING EVALUATOR SIGNATURE:	DATE: 05/14/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2024

LIC809 (FAS) - (06/04)

Page: 4 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: PRIMROSE SCHOOL OF EVERGREEN	FACILITY NUMBER: 434416249
	VISIT DATE: 05/14/2024

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

All staff have the required immunization's against pertussis, measles and influenza/ statement declining the immunization. LPA observed required Mandated Reporter Training on file for all staff.

Director was reminded 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.

Director stated that facility does not handle medications and currently has no children in care who require Incidental Medical Services (IMS). Any medications at the Facility are stored in a refrigerator in the front lobby and are inaccessible to children in care. Isolation of sick child was discussed, and Director explained that sick children will be isolated in the director's office and isolation equipment will be provided. Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, a Plan of Operation that includes IMS must be submitted to the Department. Child is always under visual supervision while in care of the facility. 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/.

Facility does not provide transportation to children, but Director understands that children cannot be left alone, unattended in parked vehicles. 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 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 interview conducted and report was reviewed with the Director, Geranny Natividad, Assistant Director, Anna Yin and Owner, Bejal Patel. As a result of today's inspection, there were no deficiencies cited.

A NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 CONSECUTIVE DAYS

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Farida Raja
LICENSING EVALUATOR SIGNATURE:	DATE: 05/14/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2024

LIC809 (FAS) - (06/04)

Page: 3 of 4