434417123-7-3-2023-07-CC-SYIP-CTDUNR-20230703154420

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434417123
Report Date: 07/03/2023
Date Signed: 07/03/2023 03:44:26 PM

Document Has Been Signed on 07/03/2023 03:44 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:	SJB - GATE WAY		FACILITY NUMBER:	434417123
ADMINISTRATOR:	PATRICIA KEITH		FACILITY TYPE:	850
ADDRESS:	7151 HANNA STREET		TELEPHONE:	(408) 516-7062
CITY:	GILROY	STATE: CA	ZIP CODE:	95020
CAPACITY: 39	TOTAL ENROLLED CHILDREN: 39	CENSUS: 0	DATE:	07/03/2023
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	09:48 AM
MET WITH:	Melissa Leza and Patricia Keith		TIME COMPLETED:	02:15 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) Samantha Yip and Ashley Lopez conducted an announced pre-licensing inspection. LPAs met with Program Director Melissa Leza and Site Director Patricia Keith and explained the reason for inspection. The purpose of this inspection is Applicant is applying for a change of location and change of capacity of 39 children. Facility is currently licensed as SJB- Antonio Del Buono #434415739. Facility is located on the Santa Clara County- Gateway campus. A fire clearance was granted on 06/27/2023. There is an area to post required postings, such as car seat, and parent's rights, personal rights. The hours of operation are Monday through Friday 7AM to 6PM. The center will be using a cell phone. LPAs toured the inside and outside of the facility. Measurement were conducted during today's inspection. The indoor measurements are as followed: Preschool (Room 3): (23.917 x 29.167 = 697.587) minus encumbered space 41.098 = 656.489 Pre-K (Room 4): (35.250 x 13.417 = 472.949) + (8.417 x 22.833 = 192.185) = 665.134 minus encumbered space 39.541 = 625.592 TOTAL INDOOR SPACE: 1,282.081 DIVIDED BY 35 = 36 children ------------------continues on 809 dated 07/03/2023 page 2---------------------

SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Samantha Yip
LICENSING EVALUATOR SIGNATURE:	DATE: 07/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2023

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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: SJB - GATE WAY	FACILITY NUMBER: 434417123
	VISIT DATE: 07/03/2023

NARRATIVE

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----------------continuation of 809 dated 07/03/2023 page 1---------------------

The outdoor measurement are as followed:
Preschool Large Yard: (106.083 x 49.917 = 5,295.345) minus encumbered space 977.284 = 4,318.060
Yard 3: 33.333 x 24.750 = 824.991
Yard 4: 29.917 x 24.750 = 740.445
= 4,318.060 + 824.991 + 740.445 = 5,883.496

TOTAL OUTDOOR SPACE: 5,883.496 divided by 75 = 78 children

There are 59 chairs, 10 tables, 60 cubbies, 40 cots, 9 sinks, and 3 toilets. All sinks for children only have cold water. There are toys and equipment for children. There is a fully charged fire extinguisher, smoke detector, and carbon monoxide detector. Program Director stated that there are no weapons, such as firearms, stored on the premise. There is a first aid kit, which has all the required items. The isolation area for sick children will be in the Office 1 and they will be using the staff bathroom for sick children.

The outdoor space is fenced. Shaded rest areas are provided by the canopy and trees. There are equipment for children, which are age-appropriate. There is an outdoor water pump in Yard 3 and Yard 4, which is accessible to children. The water does not pool under the pump. There were no bodies of water observed during today's inspection.

All meals and snacks are prepared and brought off-site. There is a kitchen to store any perishable food and drinks. Kitchen has cold and hot running water. Drinking water is provided through water fountain, Brita filter and cups. LPAs discussed that they have 180 days after licensure to receive lead testing for drinking water. LPA discussed with Program Director that there needs to be an anchored step or a broad-based platform for children when drinking fountain or sinks are too high for children. Trash can for waste have tight fitted lids.

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SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Samantha Yip
LICENSING EVALUATOR SIGNATURE:	DATE: 07/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2023

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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: SJB - GATE WAY	FACILITY NUMBER: 434417123
	VISIT DATE: 07/03/2023

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This facility plans to provide 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. There is a lock drawer in each of the classroom for medication; along with a lock medication box. LPA reminded Program Director that medication needs to inaccessible to children.

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

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, 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.

Applicant 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.

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SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Samantha Yip
LICENSING EVALUATOR SIGNATURE:	DATE: 07/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2023

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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: SJB - GATE WAY	FACILITY NUMBER: 434417123
	VISIT DATE: 07/03/2023

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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.

An updated LIC 610, LIC 999- Yard, parent and employee handbook, menu, daily activity schedule, admission agreement, job description, in-service training, and LIC 401 was obtained during today's inspection

Applicant will submit the following:
- updated LIC 500
- updated LIC 308
- permission letter from temporarily relocation site or an updated LIC 610 with new temporary relocation site
- Board of Resolution that approves the change of facility name

Exit interview conducted and report was reviewed with Program Director, Melissa Leza. LPAs advised facility representatives upon approval of Licensing Management, a license for a preschool center license will be granted and issued to Applicant and completion of the following:
- updated fire clearance
- LIC 200A with the wet signature
- fingerprint transferred

SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Samantha Yip
LICENSING EVALUATOR SIGNATURE:	DATE: 07/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2023

LIC809 (FAS) - (06/04)

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