434417245-2-25-2025-07-CC-HKAR-DE8Q8Y-20250225105732

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434417245
Report Date: 02/25/2025
Date Signed: 02/25/2025 10:58:08 AM

Document Has Been Signed on 02/25/2025 10:58 AM - 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:	SJB ROULEAU CHILD DEVELOPMENT CENTER		FACILITY NUMBER:	434417245
ADMINISTRATOR/ DIRECTOR:	IYARE ISIBOR		FACILITY TYPE:	860
ADDRESS:	1875 MONROVIA DRIVE		TELEPHONE:	(408) 573-4713
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95122
CAPACITY: 36	TOTAL ENROLLED CHILDREN: 36	CENSUS: 10	DATE:	02/25/2025
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:05 AM
MET WITH:	Melissa Leza		TIME VISIT/ INSPECTION COMPLETED:	11:45 AM

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 02/25/2025, Licensing Program Analyst (LPA)Harsimran Kaur met with Applicant Representative, Melissa Leza. The purpose of the visit was an unannounced pre-licensing inspection to add an preschool component and increase capacity. This facility has an existing toddler component facility #434415832 which will be converted to a single license upon completion of the inspection process. Facility requested to be licensed for 16 toddlers (ages 18 months - 36 months) in room 3 and 20 preschool children (2 years to entry to first grade) in room 4. The child care center will operate Monday– Friday 7:00AM – 6 PM. The fire clearance was approved on 01/31/2025.. LPA toured and measured the on-limits areas and classrooms located at the facility. The facility has a total of 2 classrooms. Preschool Classrooms measurements are: The Indoor total measurements contain a total of {703.00} square feet, which will accommodate Applicant's request for 20 preschool children. Toddler Classroom measurements are: The Indoor total measurements contain a total of {705.25} square feet, which will accommodate Applicant's request for 16 toddlers Preschool Outdoor Play measurements are: Outdoor total measurements contain a total of {2187.19) square feet, which will accommodate Applicant’s request for 20 preschool children. Toddler Outdoor Play measurements are: Outdoor total measurements contain a total of {1223.00) square feet, which will accommodate Applicant’s request for 16 toddlers.

SUPERVISORS NAME: Deborah Lowe
LICENSING EVALUATOR NAME: Harsimran Kaur
LICENSING EVALUATOR SIGNATURE:	DATE: 02/25/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/25/2025

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 4

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: SJB ROULEAU CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 434417245
	VISIT DATE: 02/25/2025

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

LPA observed all classrooms to be clean, safe, sanitary and in good repair. A comfortable temperature for children shall be maintained at all times. Furniture and equipment were observed to be maintained in good condition, free of sharp, loose or pointed parts. All materials and surfaces accessible to children, including toys, shall be free of toxic substances. All play equipment and materials used by children were observed to be age-appropriate. LPA observed no fireplace or open face heaters. LPA observed fully charged fire extinguisher, smoke and carbon monoxide detectors in the facility. There are 48 chairs, 11 tables, 38 cots, 22 cubbies, 4 toilets, 1 changing table and 8 sinks for preschool and toddlers. Staff have separate bathroom that can be utilized by sick children if needed. Sick children will be isolated in the office area of the facility. LPA observed that items that may pose a danger to children were stored in locked storage rooms inaccessible to children. LPA observed containers with tight-fitting lids for the disposal of solid wastes. LPA advised that Applicant maintains first-aid supplies in a location accessible to staff but inaccessible to children.

The Applicant shall take measures to keep the center free of flies, other insects, and rodents. Lunch and snacks provided by facility. Drinking water is readily available for the children via water fountains and children can bring their own water bottles outdoors. All food shall be safe and of the quality and in the quantity necessary to meet the needs of the children. Lunch is prepared off site via school site "SJB San Juan facility" LPA advised Applicant as per Title 22, if food is prepared off the center premises, the following shall apply: (A)The preparation source shall meet all applicable requirements for commercial food services.(B) The center shall have the equipment and staff necessary to receive and serve the food and to clean up.(C) The center shall maintain the equipment necessary for in-house food preparation, or shall have an alternate source for food preparation and service in the event of an emergency. Commercial foods shall be approved by appropriate federal, state and local authorities. All foods shall be selected, transported, stored, prepared and served so as to be free from contamination and spoilage and shall be fit for human consumption.

SUPERVISORS NAME: Deborah Lowe
LICENSING EVALUATOR NAME: Harsimran Kaur
LICENSING EVALUATOR SIGNATURE:	DATE: 02/25/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/25/2025

LIC809 (FAS) - (06/04)

Page: 2 of 4

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: SJB ROULEAU CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 434417245
	VISIT DATE: 02/25/2025

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

Facility has one toddler classroom. LPA observed 1 changing tables within arms reach to the sink.
Applicant was reminded that a child who is between 18 months and 36 months of age may participate in the toddler program with written permission from the child's authorized representative. No child in the toddler program shall be placed in the preschool program before the age of 30 months without written permission from the child's authorized representative.

Outdoor area for toddlers, and preschool children were free of hazards including, holes, broken glass dry grasses, and other debris that pose a fire hazard. Preschool outdoor activity space is physically separate from toddler and outdoor activity space. Shade was provided by trees and canopy structures. The areas around and under high climbing equipment, swings and slides had cushioned with material (tan bark) that absorbs falls. The playground is enclosed by a fence to protect children and to keep them in the outdoor activity area. LPA observed no bodies of water. The fence is at least four feet high. Any construction or equipment that could pose a hazard in the outdoor activity area shall be made inaccessible to children in care.

Drinking water from a non-contaminating fixture or container shall be readily available both indoors and in the outdoor activity area. LPA 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: Harsimran Kaur
LICENSING EVALUATOR SIGNATURE:	DATE: 02/25/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/25/2025

LIC809 (FAS) - (06/04)

Page: 3 of 4

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: SJB ROULEAU CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 434417245
	VISIT DATE: 02/25/2025

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

LPA 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 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.

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

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 with the above item discussed. This report was provided to Melissa Leza, Applicant Representative. Final license determination will be made upon review by the Licensing Program Manager.

SUPERVISORS NAME: Deborah Lowe
LICENSING EVALUATOR NAME: Harsimran Kaur
LICENSING EVALUATOR SIGNATURE:	DATE: 02/25/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/25/2025

LIC809 (FAS) - (06/04)

Page: 4 of 4