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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434417050
Report Date: 11/15/2022
Date Signed: 11/15/2022 04:07:34 PM

Document Has Been Signed on 11/15/2022 04:07 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:SAN JOSE GRAIL FAMILY SERVICESFACILITY NUMBER:
434417050
ADMINISTRATOR:ANARITA REYESFACILITY TYPE:
850
ADDRESS:2005 EAST SAN ANTONIO STREETTELEPHONE:
(408) 347-7892
CITY:SAN JOSESTATE: CAZIP CODE:
95116
CAPACITY: 28TOTAL ENROLLED CHILDREN: 28CENSUS: 0DATE:
11/15/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Anarita Reyes and Liliana Amaro OrtizTIME COMPLETED:
04:15 PM
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On 11/15/2022 at 12:30 PM, Licensing Program Analyst (LPA) Susy Cervantes met with Program Director, Anarita Reyes, and operations director, Liliana Amaro Ortiz for a pre-licensing visit. LPA toured the facility both inside and out as well as measure the areas available to the children. The program will operate Monday through Friday from 7:30 AM to 5 PM. A fire clearance for 28 children was received from the San Jose Fire Department prior to today's visit.

The following indoor measurements were taken today:

Preschool Room 21.75 x 9 = 195.75 / 35 = 5.592

Toddler Room (33.667 x 32.25) + (7.917 x 1.833) + (8.167 x 1.833) = 1,115.241 minus 31.11 (encumbered space) = 1,084.131 / 35 = 30.975

TOTAL INDOOR SPACE: 1,279.881 sq. ft. divided by 35 = 36 children.

Outdoor measurements:

Smaller Playground: 45.5 x 22 = 1001 sq. ft minus 22.25 (encumbered space) = 978.75
Larger Playground: (45.5 x 26.333) + (17.667 x 11) = 1392.4885 sq. ft. minus 78.47 (encumbered space) = 1314.0185

TOTAL PRESCHOOL OUTDOOR SPACE: 2292.77 sq. ft. divided by 75 = 30 children.

There are 4 toilets (60) and 5 sinks (75) available for the children. Only cold water is available in the children's sinks. There is a separate staff bathroom which is located next to the office. The sick child will be isolated in the Director's office and isolation equipment is provided.

Continues on report dated 11/15/2022______________________________ pg. 1/2
SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Susy Cervantes
LICENSING EVALUATOR SIGNATURE: DATE: 11/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/15/2022
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 2
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: SAN JOSE GRAIL FAMILY SERVICES
FACILITY NUMBER: 434417050
VISIT DATE: 11/15/2022
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Continuation of report dated 11/15/2022______________________________ pg. 2/2

The center will be administering medication and the medication lock boxes are located in the upper cabinets in the classrooms. First aid supplies are stored in each room. Carbon monoxide detectors are operable. There are two 3A40BC fire extinguishers that were serviced on 08/30/22. Cleaning supplies are stored under the sinks in each classroom that are locked. The center will be providing meals and snacks for the children that will be prepared in the kitchen at the facility next door: (434414756) 2003 E. SAN ANTONIO STREET, SAN JOSE 95116. Disposable dishes and cups will be utilized for the children. There are 16 cubbies, 6 tables, 18 chairs, 20 cots. LPA received copies of the items that have been ordered. Drinking water is available by water jugs.

The playground is surrounded by appropriate fencing. There are climbing structures with pour and play as resilient material. LPA observed no bodies of water. No transportation is provided by the school. Shade is provided thru large trees and an overhang. There is a working telephone number for the center which is (408) 347-7892.

Program Director was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, 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.

LPA reviewed with program director the LIC 311A, Records To Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted. LPA discussed the safe sleep regulations with program director, 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. LPA also informed program director 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.


An exit interview was conducted prior to the conclusion of today's visit and LPA advised Anarita Reyes and Liliana Amaro Ortiz that a license for 28 children is approved pending the following:

- Approval of waivers
- Management's approval
SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Susy Cervantes
LICENSING EVALUATOR SIGNATURE:

DATE: 11/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2022
LIC809 (FAS) - (06/04)
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