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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434416989
Report Date: 05/22/2024
Date Signed: 05/24/2024 11:40:44 AM

Document Has Been Signed on 05/24/2024 11:40 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 CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:EMC2 KIDS ACADEMYFACILITY NUMBER:
434416989
ADMINISTRATOR/
DIRECTOR:
BLANCA HERNANDEZFACILITY TYPE:
850
ADDRESS:4953 STEVENS CREEK BOULEVARDTELEPHONE:
(408) 409-5901
CITY:SANTA CLARASTATE: CAZIP CODE:
95051
CAPACITY: 27TOTAL ENROLLED CHILDREN: 27CENSUS: 15DATE:
05/22/2024
TYPE OF VISIT:Annual/RequiredUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:15 AM
MET WITH:Blanca HerandezTIME VISIT/
INSPECTION COMPLETED:
01:35 PM
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Licensing Program Analyst (LPA) Anna Morales conducted and Unannounced Annual Required Inspection. LPA was greeted by Director Blanca Hernandez. Days and hours of operation is Monday- Friday, 9:00am- 6:00pm, serving ages from two years entry to First Grade. Program is a part time program. Program also has a Heritage School(after school program not affiliated with Licensing Regulations) which meet in the front area of the center. Facility's License, Notification of Parents’ Rights Poster, Child Car Seat Law, Personal Rights (LIC 613A), Emergency Disaster Plan, and Earthquake Preparedness Checklist were observed to be posted. Disaster Drill was conducted in 4/28/2024.

The Preschool Program is operating in Two Classrooms (#1 and #2). LPA observed that the facility was operating in compliance with teacher to children ratio requirement. Children were engaged with activities with supervision of staff. If a child comes to the facility who exhibit symptoms of illness including, but not limited to, fever or vomiting, they are not accepted into care. Any child who become ill during the day, shall be isolated in the front area of the program until parent pick-up.

There were no bodies of water observed. Director stated that they do not have weapons on the premises. Furniture and equipment were observed to be age appropriate and in good condition, free of sharp, loose, or pointed parts. Disinfectants, cleaning solutions, and other items that are dangerous to children were stored inaccessible to children. Floors were clean. LPA observed cubbies for the children's personal belongings.

LPA observed charged Fire extinguishers. The smoke and carbon detectors are hard wired. Foods(snacks) and beverages were kept protected against contamination and spoilage. Trash cans for solid waste had tight-fitting covers on and were in good repair.

-Continue on LIC809C-
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Anna Morales
LICENSING EVALUATOR SIGNATURE: DATE: 05/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/22/2024
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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: EMC2 KIDS ACADEMY
FACILITY NUMBER: 434416989
VISIT DATE: 05/22/2024
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The Facility has no outdoor space and uses the Play Area as a multipurpose area for gross motor activities, and there is a Waiver for indoor play- space in place. The Center has a Drinking water was readily available to children indoor. Activities schedule and Snack Menu were posted. Facility provides, snacks in the morning and in the afternoon. LPA observed that food storage areas were clean and free of litter. LPA provided the Program Director with website resources on managing food allergies at school and handling medical emergencies related to food allergies.
CDC Managing Food Allergies at School
https://www.cdc.gov/healthyschools/foodallergies/index.htm
American Academy of Pediatrics Healthy Children Medical Emergencies
https://www.healthychildren.org/English/health-issues/injuries-emergencies/Pages/When-to-Call-Emergency-Medical-Services-EMS.aspx

This facility provides Incidental Medical Services – IMS however, Director stated that there are no children currently taking medications while at preschool. For IMS
information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 and link to publication. Commonly Asked Questions about Child Care Centers and the ALPDA are available at: https://www.ada.gov/resources/child-carecenters/.

The facility maintains an sign in and out system, that is updated throughout the day, containing full signatures from responsible parties. LPA observed a current Children's roster of children enrolled in the program.

A sampling of children and staff files was taken for review during today's inspection. Children records reviewed include Admission Agreement, Identification and Emergency Contact, Consent for Emergency Medical Treatment form, receipt of Parent Rights Notice, Personal Rights Notice, Medical Assessment and Immunization's.

Staff records reviewed include Criminal Record and Child Abuse Index Clearance, Health Screening Report and TB test, Immunization (Measles, Pertussis, and Flu) record and required Training. LPA reminded Director that the online AB1207 Mandated Reported Training needs to be renewed every two years. There was at least one person with current certification in Pediatric CPR and First Aid present
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Anna Morales
LICENSING EVALUATOR SIGNATURE:

DATE: 05/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2024
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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: EMC2 KIDS ACADEMY
FACILITY NUMBER: 434416989
VISIT DATE: 05/22/2024
NARRATIVE
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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.

LPA also reviewed with Director the violations that would result in an immediate assessment of civil penalty in the amount of $500. Director is encouraged to visit the Department’s website at www.cdss.ca.gov to access resources for Providers, Regulations, Online option to pay Annual License fee, Adoption of new Laws, etc.

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). LPA verified that the lead testing was completed in accordance to the Written Directives. The center does not prepare food and has filter water on the premises.

Director was informed of the MyChildCarePlan.org website; a
consumer education website that helps families obtain childcare by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Two Type B deficiencies were cited during today's inspection. Exit interview was conducted and reviewed with Director. Notice of site visit was given and must remain posted for 30 days.

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.
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Anna Morales
LICENSING EVALUATOR SIGNATURE:

DATE: 05/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2024
LIC809 (FAS) - (06/04)
Page: 3 of 4
Document Has Been Signed on 05/24/2024 11:40 AM - It Cannot Be Edited


Created By: Anna Morales On 05/22/2024 at 12:31 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: EMC2 KIDS ACADEMY

FACILITY NUMBER: 434416989

DEFICIENCY INFORMATION FOR THIS PAGE:

VISIT DATE: 05/22/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview and record review, the licensee did not comply with the section cited above. Director's Mandated Reporter Training expired on 8/2/2023, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/05/2024
Plan of Correction
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Director stated that she will submit a copy of her current Mandated Reporter Training to CCL by the POC date.
Type B
Section Cited
CCR
101161(a)
Limitations on Capacity and Ambulatory Status
(a) A licensee shall not operate a child care center beyond the conditions and limitations specified on the license, including the capacity limitation.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview and record review, the licensee did not comply with the section cited above. Director accepted C1, who is younger than two years of age began Preschool on 5/6/2024, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/24/2024
Plan of Correction
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Director stated that she will submit a plan to ensure that she operates in accordance with the terms specified in the plan of operation at all times. Director stated that C1 will turn two at the end of June 2024, and she will submit an Age Exception to CCL by the POC date.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Gladys Kuizon
LICENSING EVALUATOR NAME:Anna Morales
LICENSING EVALUATOR SIGNATURE:
DATE: 05/22/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/22/2024


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