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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434416351
Report Date: 06/23/2022
Date Signed: 06/23/2022 02:53:49 PM

Document Has Been Signed on 06/23/2022 02:53 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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:PLAY 'N' LEARN PRESCHOOL, INCFACILITY NUMBER:
434416351
ADMINISTRATOR:TAMMY LARIZFACILITY TYPE:
830
ADDRESS:3800 NARVAEZ AVENUETELEPHONE:
(408) 269-9004
CITY:SAN JOSESTATE: CAZIP CODE:
95136
CAPACITY: 15TOTAL ENROLLED CHILDREN: 15CENSUS: 6DATE:
06/23/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
08:21 AM
MET WITH:Tammy Lariz TIME COMPLETED:
12:22 PM
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Licensing Program Analysts (LPAs) Stephanie Collins and Melvin Matos conducted an unannounced Pre-Licensing inspection with Tammy Lariz, Application Representative/ Director and explained the nature of today's inspection. The Applicant Representative/Director has applied for an Infant License. There is an existing licensed Preschool program (#434413711) operating at the same address. A Fire Clearance was approved by San Jose Fire Prevention Department on 3/16/22.
LPA's observed appropriate teacher to child ratio. The infant program is currently operating under a COVID-19 waiver and thus staff and children were present during today's inspection. The Infant program is operating Monday through Friday from 06:30AM to 06:00PM, serving children ages 6 months -24 months. The Infant program is utilizing Area 7 (one classroom) for the children The following measurements taken today 6/23/2022

INDOOR MEASUREMENT
( INFANT ROOM Area 7 )
(Total sq. ft.) – (Encumbered)
= (30 sq ft.) x (17 sq. ft.) = 510.00 sq. ft. minus 51.97 sq. ft.
= 458.03 sq. ft.
TOTAL Infant INDOOR SPACE =458.03 sq. ft. divided by 35
= 14 children.
OUTDOOR MEASUREMENTS:
INFANT Playground
(Total sq. ft.) – (Encumbered)
(52.417 sq. ft) x (31.75 sq. ft ) = 1664.24 minus 60.14 (encumbered space)
= 1604.10 sq, ft
TOTAL INFANT OUTDOOR SPACE: 1604.10 sq. ft divided by 75 = 21 children
(Waiver with schedule to be submitted for shared outdoor space).
SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Stephanie Collins
LICENSING EVALUATOR SIGNATURE: DATE: 06/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/23/2022
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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: PLAY 'N' LEARN PRESCHOOL, INC
FACILITY NUMBER: 434416351
VISIT DATE: 06/23/2022
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The Infant playground is located next to the preschool playground. LPAs observed infant playground surrounded and separated from the preschool playground by at least a 4' high fence. Shade is provided by canopies and building overhang. Artificial turf with padding is utilized for resilient material around and under the play structure in the Infant playground. LPAs observed the outdoor activity space is equipped with a variety of age-appropriate toys and equipment. LPAs observed no bodies of water.

There is one children's sink has cold water only. LPAs observed a changing table within arm’s reach of the sink. LPAs observed a trash can with a tight-fitting lid for diapers for disposal of solid waste. There are hooks and separate cubbies available for children’s personal items. There are separate staff restrooms (2 sink and 2 toilet ). Children who become ill will be isolated in Director's office with isolation equipment. The infant classroom is furnished with age appropriate toys. First aid supplies, medication, and cleaning supplies are stored inaccessible to children.

LPAs observed functioning fire extinguish (2 A-10-BC), smoke/carbon monoxide detectors in classroom. Drinking water is available indoors/outdoors via bottles and pitchers. No transportation is provided.

LPAs observed microwave. dishwasher, and hot and cold running water in the Infant Room. Feeding chairs and other appropriate seating equipment will be used to seat infants during feeding. Tammy understands that infants shall be held during feedings if they are unable to sit unassisted and propped bottles are not permitted. Tammy understands that the Needs and Service Plan needs to be updated at least once every 3 months. Tammy understands that a baby walker or any similar items shall not be used on the premise of a child day care facility. Infants that do not require cribs will nap on cots. Tammy understands that each crib or cot shall be occupied by only one infant at a time and each infant's bedding shall be used for him/her only. Such bedding shall be replaced daily or and when wet or soiled.

LPAs discussed the safe sleep regulations with Applicant Representative/Director Tammy Lariz 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. LPAs also informed Tammy 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.
SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Stephanie Collins
LICENSING EVALUATOR SIGNATURE:

DATE: 06/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/23/2022
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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: PLAY 'N' LEARN PRESCHOOL, INC
FACILITY NUMBER: 434416351
VISIT DATE: 06/23/2022
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Applicant Representative/Director, Tammy Lariz, was reminded that all adults 18 and over, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.
Incidental Medical Services (IMS) policy was discussed with Applicant Representative/Director, Tammy Lariz. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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)/ (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

LPAs reviewed with Applicant Representative/Director, Tammy Lariz the LIC 311A, Records to Be Maintained at The Facility, for child’s records, personnel records, administrative records, and documents to be posted.
Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication plat form. To receive important licensed-related information to licensed facilities, visit the CCLD website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

An application was received for 15 however measurements taken today measured for 14 Infant children in the infant room. .
Correction to the application/plan of operation are still being reviewed by LPM Mary Segura and final approval will be made when the application documents are completed,

Pending Documents:
1: Updated Application for a Child Care Center License (LIC 200A)
2:Updated fire inspection approval for 14 infant children.

Exit interview conducted and report was reviewed with the Applicant Representative/Director, Tammy Lariz.
SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Stephanie Collins
LICENSING EVALUATOR SIGNATURE:

DATE: 06/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/23/2022
LIC809 (FAS) - (06/04)
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