434416250-5-15-2024-07-CC-FRAA-D5AK9A-20240515074157

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434416250
Report Date: 05/14/2024
Date Signed: 05/15/2024 07:42:07 AM

Document Has Been Signed on 05/15/2024 07:42 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:	434416250
ADMINISTRATOR/ DIRECTOR:	GERANNY NATIVIDAD		FACILITY TYPE:	840
ADDRESS:	3008 ABORN ROAD		TELEPHONE:	(408) 440-8215
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95135
CAPACITY: 22	TOTAL ENROLLED CHILDREN: 22	CENSUS: 16	DATE:	05/14/2024
TYPE OF VISIT:	Annual/Required	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	02:00 PM
MET WITH:	Geranny Natividad		TIME VISIT/ INSPECTION COMPLETED:	04:45 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 2:00pm, Licensing Program Analyst (LPA), Farida Raja, met with Director, Geranny Natividad and Owner, Bejal Patel for an unannounced annual inspection in the School Age Program. The facility is licensed to serve children ages 5-12 years in one classroom (Explorers). Preschool (434416248) and infant license (434416249) are present on the same premises. LPA observed the required posted materials in the lobby and Emergency Disaster Plan, Dietary Restrictions and Allergy List and daily activity schedule in the classroom. Days and hours of operation are Monday through Friday, 2:00 am to 6:00 pm during school days and 8:00am to 6:00pm during spring and summer camp. At 2:37pm, LPA and Director toured the indoor and outdoor areas of the School Age Program during today's inspection. LPA observed 2 teachers and 8 children and more children were arriving. Classroom, children's restrooms, staff restrooms, kitchen and office area were inspected. There is a working telephone in the facility (408-440-8215). Children were engaged in worksheets under supervision and guidance from staff. Facility has central heating/cooling for comfort of children. Director states that there are no weapons or firearms on the premises. Disinfectants, cleaning products and first aid supplies were stored inaccessible to the children in locked cabinets. Furniture and equipment were age appropriate and in good condition, free of sharp, loose, or pointed parts. Floors were clean and free from tripping hazards. LPA observed solid waste container with tight-fitting lid in the room. Two sinks and two toilets were observed to be safe, sanitary, and in working condition. Staff has two separate bathrooms that can be utilized by sick children if needed. Drinking water is readily available for children indoors and outdoors via 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. 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 3

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: 434416250
	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

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 two snacks to school age children. Menu was observed to be posted. Food and beverages were stored safely to prevent contamination and spoilage. Food storage and preparation areas were observed to be sanitary. All food and beverages that require refrigeration are stored in covered containers. 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.

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. Areas around and under high climbing structures are cushioned with artificial glass as resilient material to absorb falls. LPA observed rubber mats under slides and the tire swing to absorb falls. Shade is provided by canopy. 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. Six (6) children's files were reviewed during today's inspection. All children's files were complete with required documentation.

Two (2) 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 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 3

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: 434416250
	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. Child is always under visual supervision while in care of the facility. 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. 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 provides transportation to children. LPA reminded Director that children cannot be left in parked vehicles unattended at any time, the motor vehicles used to transport children shall be maintained in safe operating conditions, and all vehicle occupants must be secured in an appropriate restraint system. 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 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 3