434417052-11-9-2022-07-CC-JCRZ-CL22LX-20221109163016

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434417052
Report Date: 11/09/2022
Date Signed: 11/09/2022 04:30:25 PM

Document Has Been Signed on 11/09/2022 04:30 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:	KINDERWOOD PRESCHOOL		FACILITY NUMBER:	434417052
ADMINISTRATOR:	CHEYENNE BOHN		FACILITY TYPE:	830
ADDRESS:	5560 ENTRADA CEDROS		TELEPHONE:	(408) 839-5669
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95123
CAPACITY:	30	CENSUS: 18	DATE:	11/09/2022
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Gireesh Malhotra		TIME COMPLETED:	04:45 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analysts (LPAs) Janette Cruz and Mel Matos met with Applicant Representative, Gireesh Malhotra, Applicant, for the purpose of conducting a pre-licensing inspection. This was in response to an application for a change of ownership. Also present today was Applicant’s wife/current facility director of ABC Preschool & Daycare (015700561) and Footsteps Preschool (434414537), Anupama Malhotra, The Infant Program will operate Monday through Friday from 6:00 AM to 6:00 PM, serving preschool children ages 6 months to 24 months old. The Infant program will be utilizing Infantl Rooms 1 and 2. There is also a Preschool program on site (#434417051) that will utilizing Rooms 3,4, & 5. LPAs toured and measured the indoor and outdoor areas of the facility during today's inspection. Indoor Activity Space: Room 1 : 39.500 x 14.667= 579.346 minus 25.23 (encumbered space) = 554.116 Room1 : 24.417 x 21.917 = 535.147 minus 25.23 (enucumbered space) = 509.917 *TOTAL INDOOR SPACE = 1114.493 sq. ft. divided by 75 = 31 infant children* The facility has 1 sink (15) and 2 changing tables available for the preschool children. The sink to be used by children only have cold running water. Staff bathroom is located by the facility hallway. There is a separate staff bathroom not utilized by the children which an isolated child can use if needed. Sick children will be isolated in the Director's Office and isolation equipment will be provided. Staff and children's bathrooms are clean, sanitary, and operable.

SUPERVISOR'S NAME: Diana Stephenson	TELEPHONE: (408) 324-2128
LICENSING EVALUATOR NAME: Janette Cruz	TELEPHONE: (408) 334-8312
LICENSING EVALUATOR SIGNATURE:	DATE: 11/09/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/09/2022

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: KINDERWOOD PRESCHOOL	FACILITY NUMBER: 434417052
	VISIT DATE: 11/09/2022

NARRATIVE

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LPAs observed containers with tight-fitting lids for the disposal of solid waste. LPAs observed a complete First Aid kit in the Facility Cleaning supplies are stored in high cabinets in the classroom . LPAs observed functioning smoke/carbon monoxide detectors and appropriate lighting in each classroom. The facility has central heating and air conditioning. Gireesh stated that the facility plans to administer medications.

Gireesh understands that the facility must be kept free of flies, other insects & rodents. LPAs observed that all furniture and equipment indoors are in good condition and safe for the children. Drinking water will be readily available for the children indoors via drinking fountains. Transportation will not be provided by the facility.

The facility will provide meals and snacks. The facility has an off-limits kitchen area that is clean and equipped with a sink with hot and cold running water, refrigerator, and storage space for food. Disposable utensils and plates will be utilized by the facility.

LPA observed that facility is equipped with appropriate furniture and equipment including but not limited to: 17 chairs, 12 cribs, 3 tables, 44 cubbies, 13 mats, and 6 high chairs. There is adequate supplies and toys safe for the infants in each classroom.

OUTDOOR MEASUREMENTS:
Playground 1/2 : 13.250 x 59.667 = 790.588

TOTAL OUTDOOR SPACE = 790.588 sq. ft. divided by 75 = 10 children

LPAs observed that outdoor space for infants is separated by a fence from the space used by preschool children, LPAs observed the playground is fully fenced, free from hazards, holes, broken items and debris. Shaded areas provided by trees and building overhang. The areas under and around the play structure is cushioned with material (artificial grass with padding) that will absorb a fall. Drinking water will be provided by individual water bottles and drinking fountain. No bodies of water observed.

Incidental Medical Services (IMS) policy was discussed. 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

SUPERVISOR'S NAME: Diana Stephenson	TELEPHONE: (408) 324-2128
LICENSING EVALUATOR NAME: Janette Cruz	TELEPHONE: (408) 334-8312
LICENSING EVALUATOR SIGNATURE:	DATE: 11/09/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/09/2022

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: KINDERWOOD PRESCHOOL	FACILITY NUMBER: 434417052
	VISIT DATE: 11/09/2022

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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

Applicant Representative 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.

LPAs reviewed with Applicant Representative 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 platform. To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

Exit interview conducted and report was reviewed with Gireesh Malhotra, Applicant.
LPAs advised him that a license for 30 infants will be submitted to Licensing Management for the final stage of approval once the following item(s) have been received:
1) Waiver request for shared use of Playground 3 with the Preschool program.
2) Receipt of qualified infant director and assistant infant director documents.
3) Updated control of property
4) Updated LIC 309 Administrative Organization
5) Updated LIC 308 Designation of Facility Responsibility
6) Updated LIC 500 Personnel Report
7) Updated LIC 610 Emergency Disaster Plan
8) Parent Handbook that includes needs and services plan addressing Infant Safe Sleep requirements.
9) Waiver request for shared sink (one sink for every 15 infants)

SUPERVISOR'S NAME: Diana Stephenson	TELEPHONE: (408) 324-2128
LICENSING EVALUATOR NAME: Janette Cruz	TELEPHONE: (408) 334-8312
LICENSING EVALUATOR SIGNATURE:	DATE: 11/09/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/09/2022

LIC809 (FAS) - (06/04)

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