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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434416313
Report Date: 06/29/2022
Date Signed: 06/29/2022 11:29:04 AM

Document Has Been Signed on 06/29/2022 11:29 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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:FAITH HOPE & LOVE PRESCHOOLFACILITY NUMBER:
434416313
ADMINISTRATOR:LI-RONG TSENGFACILITY TYPE:
850
ADDRESS:6350 RAINBOW DRIVETELEPHONE:
(408) 255-1859
CITY:SAN JOSESTATE: CAZIP CODE:
95129
CAPACITY: 20TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
06/29/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Tseng Li-RongTIME COMPLETED:
11:45 AM
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Licensing Program Analyst (LPA), Pete Hernandez, met with Center Director, Tseng Li-Rong for an unannounced Required 1 Year Inspection in the Preschool Program. The facility has two waivers on file for shared bathroom and shared bathroom for ill children. LPA observed the 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), Sample Menus, and Activity Schedule. LPA did not observe any children or Teachers other than the Director because she has not opened the facility due to Covid-19 since the facility was first licensed last year.
LPA toured the indoor and outdoor areas of the Facility during today's inspection.
LPA observed that the preschool room is clean and safe for all children and staff. When they open drinking water will be readily available for the children in each room and in the outdoor playground area via water pitchers and disposable cups or personal bottles. LPA observed solid waste containers with tight-fitting lids in each room. Staff and children's bathrooms are clean, sanitary, and operable. There is a separate staff bathroom not utilized by the children. Director Li states that there are no weapons or firearms on the premises.

REPORT CONTINUED ON THE FOLLOWING PAGE (PAGE #2 - REPORT DATED 06/29/2022):
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Pietro Hernandez
LICENSING EVALUATOR SIGNATURE: DATE: 06/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/29/2022
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: FAITH HOPE & LOVE PRESCHOOL
FACILITY NUMBER: 434416313
VISIT DATE: 06/29/2022
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CONTINUATION OF PREVIOUS PAGE (PAGE #1 - REPORT DATED 06/29/2022):

The facility plans to provide AM and PM snacks plus breakfast and lunch. Storage areas are clean, free of litter & rubbish, and free of rodents and other vermin. All food and beverages that require refrigeration are stored in covered containers at 45 degrees F or less. Cleaning supplies are inaccessible to the children.

LPA was unable to review staff files during today's inspection since they do not have any staff. The Directror has received criminal record and child abuse index clearances or exemptions. LPA reminded the Center Director of the applicable civil penalties for those adults who have not received fingerprint clearances, are not associated to the license and who come in contact with or provide care and supervision to the children. Penalty amounts: $100.00 per person per day, minimum of $100.00 to a maximum of $500.00 per person for an initial violation and a minimum of $100.00 to a maximum of $3000.00 per person for any subsequent violations within a 12-month period. All teacher files reviewed contain the required transcripts/verification of experience. Director understands the conditions, limitations, and capacity specifications of the Facility license. Director understands that children shall be visually supervised at all times. And that a teacher or aide is required to be present in the nap room any time a child is placed in the room.

LPA observed all furniture and equipment indoors is in good condition and safe for the children. The playground areas utilized by children is surrounded by appropriate fencing and the outdoor surfaces are safe for the children. LPA observed that the outdoor equipment is age appropriate and in good condition. There is sufficient resilient material on the outdoor playground areas. LPA did not observe any bodies of water.

LPA did not obtain a Facility Roster because they have not opened yet.

LPA discussed the that if, in the future, the facility plans to go inactive they need to notify CCLD. Director did sign the inactive form and plans to open on August 15th 2022.
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Pietro Hernandez
LICENSING EVALUATOR SIGNATURE:

DATE: 06/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2022
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: FAITH HOPE & LOVE PRESCHOOL
FACILITY NUMBER: 434416313
VISIT DATE: 06/29/2022
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CONTINUATION OF PREVIOUS PAGE (PAGE #2 - REPORT DATED 06/29/2022):

LPA informed Licensee that fire/disaster drills must be practiced at least once every six months and documented. Licensee understands this requirement.

Director has a current Mandated Reporter certificate.

Director has current CPR and First Aid Certificate. Linda's expires on 10/23/23. At least one staff member on site has a current CPR and First Aid certification on file. Director understands that there shall be at least one person, with valid CPR and First Aid certifications, on site.

LPA was unable to review the files children since the facility has not opened yet.

LPA reviewed the files of 1 staff and all the files contained the required documentation.

TYPE A language: Should there ever be issuance of Type A citations today, a copy of the Facility Evaluation Report LIC809 has to be posted on the wall and a copy to be given to all parents of currently and newly enrolled children for next 12 months. In addition, copy of LIC9224 Statement Acknowledging Receipt of Licensing Reports need to be signed and kept in child files.

A deficiency is not being cited based on the LPA observation, interviews conducted, and record review in accordance with the California Code of Regulations, Title 22. An exit interview was conducted, and Plan of Corrections were reviewed and developed with the licensee. A copy of this report and appeals rights were discussed and left with the Licensee,Tseng Li-Rong , whose signature on this form confirm receipt of these documents.

A NOTICE OF SITE VISIT WAS ISSUED, POSTED NEAR THE ENTRANCE TO THE FACILITY, AND MUST REMAIN POSTED FOR 30 DAYS.
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Pietro Hernandez
LICENSING EVALUATOR SIGNATURE:

DATE: 06/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2022
LIC809 (FAS) - (06/04)
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