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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434416352
Report Date: 06/23/2022
Date Signed: 06/23/2022 07:25:22 PM

Document Has Been Signed on 06/23/2022 07:25 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:
434416352
ADMINISTRATOR:TAMMY LARIZFACILITY TYPE:
840
ADDRESS:3800 NARVAEZ AVENUETELEPHONE:
4082699004
CITY:SAN JOSESTATE: CAZIP CODE:
95136
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 20DATE:
06/23/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
12:47 AM
MET WITH:Tammy LarizTIME COMPLETED:
03:15 AM
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Licensing Program Analysts (LPAs) Stephanie Collins and Melvin Matos conducted an unannounced Pre-Licensing inspection with Tammy Lariz, Applicant Representative/ Director and explained the nature of today's inspection. The Applicant Representative/Director has applied for a School Age 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 School Age program is currently operating under a COVID-19 waiver and thus staff and children were present during today's inspection. The School Age program operating Monday through Friday from 06:30AM to 06:00PM, serving children ages 4 years 12 years of age . The School Age is utilizing the School Age class room Area 8
The following measurements taken today 6/23/2022
INDOOR MEASUREMENT
(School Age Room: Area 8)
(Total sq. ft.) – (Encumbered)
(19.583 sq ft.) x (24.667 sq. ft.) = 483.05 sq. ft. minus 37.30 sq. ft. = 445.76 sq. ft
(13.167 sq. ft) x ( 5.333 sq. ft. ) = 70.22 sq. ft.
(18.5 sq. ft. X (21.333 sq. ft ) = 394.66 sq.ft.

TOTAL SCHOOL AGE INDOOR SPACE = 910.64 sq. ft. divided by 35 = 26 children.

OUTDOOR MEASUREMENTS:
School Age Playground (Sandbox & Grassy area )
(Total sq. ft.) – (Encumbered)
(30.8 sq ft ) x (25.9 sq. ft ) = 797.72 sq. ft minus 48.32 sq.ft = 749.40 sq.ft.
(63.1 sq ft) x ( 57..49) sq.ft. = 3627.62 sq ft
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)
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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: PLAY 'N' LEARN PRESCHOOL, INC
FACILITY NUMBER: 434416352
VISIT DATE: 06/23/2022
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TOTAL OUTDOOR SPACE: 4,377.02 sq. ft divided by 75= 58 children
(Waiver with schedule to be submitted for shared outdoor space).
Furniture and equipment for school age children to use were observed. There were tables and chairs to accommodate the maximum capacity of children requested. A fully charged fire extinguisher was observed ( 2 A-10 BC) with a carbon monoxide detector in the school age classroom. LPA’S observed that there dedicated restrooms assigned to the School Age Program within the class room ; 2/30 toilet 3/45 sinks and There are separate staff restroom with 2 toilet and 2 sink available to staff. Children who become ill will be isolated in Director's office with isolation equipment.
The children will be sharing the playground with the preschool program per waiver guidelines. The outdoor activity space is enclosed with fencing. Shade is provided by canopy. Pitchers of water are made available to children as well here own individual water bottle to ensure that drinking water is available. Per Applicant Representative /Director Tammy, no weapons or ammunition will are stored in or on the premises. The program will not be providing transportation. Facility will provide AM and PM snack. LPA’S observed containers used for storage of solid wastes has tight-fitting covers. Detergents, cleaning compounds, sharps, medicines, and other items which could pose a danger if readily available to children were stored where they are inaccessible to children in care. Storage areas have locks.

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

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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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: 434416352
VISIT DATE: 06/23/2022
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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.

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, and

Pending Documents:
1: Playground Waiver request for Preschool and school Age programs

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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