434417115-9-11-2023-07-CC-ALOZ-CVKU5S-20230911151713

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434417115
Report Date: 09/11/2023
Date Signed: 09/11/2023 03:17:20 PM

Document Has Been Signed on 09/11/2023 03:17 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
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME:	IMAGINE CHRISTIAN PRESCHOOL		FACILITY NUMBER:	434417115
ADMINISTRATOR:	RYAN LEE		FACILITY TYPE:	850
ADDRESS:	2575 COIT DRIVE		TELEPHONE:	(408) 500-9507
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95124
CAPACITY: 42	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	09/11/2023
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Ryan Lee		TIME COMPLETED:	03:40 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) Ashley Lopez and Mel Matos conducted an announced pre-licensing inspection. LPAs met with Applicant Representative/Director Ryan Lee and explained the reason for the inspection. Purpose of today's inspection: Ryan is applying for preschool license with a capacity of 42 children, ages 2 to 5 years old. LPAs note that the Facility is located on the premises of the Cambrian Park Community Church. A fire clearance from San Jose Fire Department was granted on 8/11/23. The hours of operation will be Monday through Friday 8:00AM to 5:30PM. LPAs observed the required postings that are placed near the front entrance of the center. LPAs toured the Facility and measurements of the indoor and outdoor space were taken during today's inspection. The indoor and outdoor measurements are as follows: Room #1 11.500 x 8.667 = 99.670 11.500 x 18.083 = 207.954 23.250 x 23.333 = 542.492 encumbered space: 4.583 x 1.333 = 6.109 99.670 + 207.954 + 542.492 - encumbered 6.109 = 844.007 Sq Ft Room #2 11.500 x 11.083 = 127.454 11.083 x 11.500 = 127.454 5.500 x 4.167 = 22.918 17.750 x 26.250 = 465.937 encumbered space: 4.250 x 1.333 = 5.665 127.454 + 127.454 + 22.918 + 465.937 - encumbered 5.665 = 738.098 Sq Ft Total Indoor Space measurements: 844.007 + 738.098 = 1,582.105 divided by 35 = 45 Children

SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Ashley Lopez
LICENSING EVALUATOR SIGNATURE:	DATE: 09/11/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2023

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-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: IMAGINE CHRISTIAN PRESCHOOL	FACILITY NUMBER: 434417115
	VISIT DATE: 09/11/2023

NARRATIVE

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Playground:
34.167 x 32.083 = 1096.179
81.250 x 49.250 = 4001.562
encumbered space: none
1096.179 + 4001.562 = 5097.741 Sq Ft

Total Outdoor Space Measurements: 5,097.741 divided by 75 = 67 children

The Facility has adequate lighting and heating/air conditioning in both Rooms. LPAs did observe a barricade fireplace in Room 1. There are no wall heater units in the Facility. Children will bring their lunches from home and the facility will only provide AM and PM snacks to the children. Cleaning and sanitation of dishes and utensils will be done via hand washing. Disposable utensils and plates will be utilized by the Facility. LPAs observed solid waste containers with a tight-fitting lid in both Rooms. Drinking water inside will be provided through reusable water bottles and filtered water. Drinking water outside will be provided through reusable water bottles, disposable cups/water pitchers.

LPAs observed 49 chairs, 6 tables, 60 cubbies, 47 hooks, 19 cots, 3 mats, 6 sinks, and 6 toilets. There is only cold running water in the bathroom sinks. Kitchen sink area in Room 2 has hot and cold running water and refrigeration for food storage and food preparation. LPAs advised Ryan to keep cleaning supplies inaccessible to children in higher cupboards or securely locked lower cupboards. There are enough toys and supplies for the capacity of children requested. All equipment and furniture are safe and age appropriate. Ryan understands that each child who naps needs to have their own mat or cot. LPAs advised Ryan that more nap cots or mats will be required for the requested capacity.

Staff have a separate staff bathroom on site that can be utilized by sick children if necessary. Sick children will be isolated in the director's office area of the facility and isolation equipment is available. There is a fully charged fire extinguisher, smoke detectors, and carbon monoxide detectors. Ryan states that there are no weapons, such as firearms, stored on the premise. LPAs observed first aid kit, which was missing the first aid manual and thermometer.

SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Ashley Lopez
LICENSING EVALUATOR SIGNATURE:	DATE: 09/11/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2023

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-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: IMAGINE CHRISTIAN PRESCHOOL	FACILITY NUMBER: 434417115
	VISIT DATE: 09/11/2023

NARRATIVE

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The outdoor space is fenced. LPAs discussed with Ryan about supervision when children are in the outside playground area. Shaded rest area is provided by building overhangs. There were no bodies of water observed during today's inspection. Areas around the play structure and slide have resilient material. Transportation will not be provided by the Facility.

LPAs reviewed the LIC 311A, Records to Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted.

Ryan states that the Facility plans on administering medication to the children and providing Incidental Medical Services – IMS. For IMS information, see PIN 22-02-CCP. A 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) or (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.

Ryan Lee, Applicant representative/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, 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.

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 platforms. 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.

SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Ashley Lopez
LICENSING EVALUATOR SIGNATURE:	DATE: 09/11/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2023

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-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: IMAGINE CHRISTIAN PRESCHOOL	FACILITY NUMBER: 434417115
	VISIT DATE: 09/11/2023

NARRATIVE

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Ryan Lee, Applicant Representative/Director was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Exit interview conducted and report was reviewed with the Applicant Representative/Director Ryan Lee.

LPAs advised Ryan that upon approval of Licensing Management and completion of the listed items below, a license for a preschool center will be granted and issued.

1. First Aid Manual and thermometer have been added to the First Aid Kit

2. Two Faucets, located in the children's bathroom in Room #1, are working

SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Ashley Lopez
LICENSING EVALUATOR SIGNATURE:	DATE: 09/11/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2023

LIC809 (FAS) - (06/04)

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