<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434417198
Report Date: 11/21/2024
Date Signed: 11/21/2024 12:30:08 PM

Document Has Been Signed on 11/21/2024 12:30 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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:BELLGRAD STEAM ACADEMY - HACIENDAFACILITY NUMBER:
434417198
ADMINISTRATOR/
DIRECTOR:		MADLEN IVAN QUINCYFACILITY TYPE:
860
ADDRESS:1290 KIMBERLY DRIVETELEPHONE:
(408) 568-3674
CITY:SAN JOSESTATE: CAZIP CODE:
95118
CAPACITY: 120TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
11/21/2024
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:15 AM
MET WITH:Arukulmar Sundarraman, Swetha NadamuniTIME VISIT/
INSPECTION COMPLETED:
12:50 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
On 11/21/24 Licensing Program Analysts (LPAs) Janette Cruz and Harsimran Kaur met with Arulkumar Sundarraman, Swetha Nadamuni and Madlen Ivan Quincy, Applicant representatives. The purpose of the visit was an announced pre-licensing inspection at the facility to ensure the health, safety and personal rights as required by Title 22 and Health and Safety Regulations governing California Child Care Centers will be met. Applicants requested for a center change of ownership with capacity of 120 school-age children ages 4.9 - 15 years in rooms 5, 6, 17B and 18. The facility will operate Monday–Friday during the hours of 7:00AM - 9:00 AM and 2pm- 6PM. However facility will operate full-time on some holidays from 7AM-6PM. The facility is located on a functioning school site: Hacienda Environmental Science Magnet School. The facility submitted to the Department a letter approved by San Jose Unified School District signed by principal of Hacienda Environmental Science Magnet School stating that each classroom has an approved capacity of 30 children, total capacity 120. The fire clearance was approved by the San Jose Fire Department on August 16, 2024. Facility is operating under existing school age program #434416162. There were no children present during today's inspection.

Since this School-Age Program will be operating on a functioning school site, the Program is exempt from square-footage requirements for indoor and outdoor activity space, and toilet requirements for child day care centers, pursuant to Health and Safety Code Section 1596.806. LPAs inspected indoor and outdoor areas. LPAs observed adequate number of tables and chairs available for capacity of children requested.

LPAs observed that there are toilets for school age children for both sexes to ensure individual privacy. Children will also have access to the restrooms, sinks, and water fountains on the school site. The
SUPERVISORS NAME: Deborah Lowe
LICENSING EVALUATOR NAME: Janette Cruz
LICENSING EVALUATOR SIGNATURE: DATE: 11/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/21/2024
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 3
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: BELLGRAD STEAM ACADEMY - HACIENDA
FACILITY NUMBER: 434417198
VISIT DATE: 11/21/2024
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
26
27
28
29
30
31
32
children will be using the elementary school's field and playground for outdoor activities. The outdoor activity space is enclosed with adequate fencing. Areas under high climbing equipment has material that absorbs falls (artificial grass). Shade is provided by trees and building overhang. Facility has water fountains indoor and outdoor and children will be bringing their own water bottle to ensure that drinking water is available. The Program will not be providing transportation.

Facility will provide an afternoon snack. LPAs observed container used for storage of solid wastes has tight-fitting cover on. LPAs observed that items that may pose a danger to children were stored inaccessible to children. At the end of the day, facility will receive janitorial service provided by the school district.

Drinking water from a non-contaminating fixture or container shall be readily available both indoors and in the outdoor activity area. LPAs advised per Health and Safety Code 1597.16(a)(1) Lead Testing and PIN-21-21-CCP Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010 to test their drinking water for lead contamination between January 1, 2020 and January 1, 2023, and then every 5 years after the date of the first test.
Per Written Directive 100700(c)(1) Written Directives for Lead Testing (1) For a license issued on or after July 1, 2022, initial testing results shall be received and posted within 180 days of licensure.

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.
SUPERVISORS NAME: Deborah Lowe
LICENSING EVALUATOR NAME: Janette Cruz
LICENSING EVALUATOR SIGNATURE:

DATE: 11/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2024
LIC809 (FAS) - (06/04)
Page: 2 of 3
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: BELLGRAD STEAM ACADEMY - HACIENDA
FACILITY NUMBER: 434417198
VISIT DATE: 11/21/2024
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
26
27
28
29
30
31
32
LPAs discussed the safe sleep regulations with 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. LPAs also informed [applicant, licensee, or facility representative] 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.

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

Applicants were 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.

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 exit interview was conducted and copy of appeal rights and this report was provided to Arulkumar Sundarraman, Applicant Representative. Final license determination will be made upon review by the Licensing Program Manager.
SUPERVISORS NAME: Deborah Lowe
LICENSING EVALUATOR NAME: Janette Cruz
LICENSING EVALUATOR SIGNATURE:

DATE: 11/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2024
LIC809 (FAS) - (06/04)
Page: 3 of 3