434417303-5-3-2023-07-CC-MMOO-CRGQ6D-20230503115324

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434417303
Report Date: 05/03/2023
Date Signed: 05/03/2023 11:55:43 AM

Document Has Been Signed on 05/03/2023 11:55 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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME:	EDUCARE CALIFORNIA AT SILICON VALLEY HEADSTART/INF		FACILITY NUMBER:	434417303
ADMINISTRATOR:	ELVIRA C/RENEE G.		FACILITY TYPE:	830
ADDRESS:	1399 SANTEE DRIVE		TELEPHONE:	(408) 453-6900
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95122
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	05/03/2023
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	08:55 AM
MET WITH:	Renee Garcia & Reyna Dominguez		TIME COMPLETED:	12:10 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) Marilou Monico and Deanna Villagrana met with Renee Garcia, Supervisor Head Start Preschool Sites and Reyna Dominguez, Early Head Start Program Manager, for the purpose of conducting a Prelicensing Inspection. Fire clearance was approved on April 18, 2023. The Infant Program will be operating Monday through Friday from 8:00 AM to 5:00 PM, serving children from 6 months to 2 years. LPAs toured the facility during today's inspection as well measured the space available for the children. The following are indoor measurements and information: Room 140/Madrone 2: 39.000 x 19.500 = 760.5 minus 141.323 (encumbered space) = 619.177 *TOTAL INFANT INDOOR SPACE = 619.177* *sq. ft. divided by 35 = 17 children* The Infant Program has 2 sinks (30) available for the children. The sinks only have cold running water. There is a diaper changing table that is within arm's reach of a sink. Sick children will be isolated in the Educare Waiting Room/Office adjacent to Maple 3 Room and isolation equipment will be provided. The sick children will be using the staff bathroom located next to Maple 4 Room if needed and will be accompanied by a staff member. The staff bathroom is clean, sanitary, and operable. LPAs observed containers with tight-fitting lids for the disposal of solid waste and diapers. First aid supplies are stored in Madrone 2 inaccessible to children. Cleaning supplies are stored out of reach of children. LPAs observed smoke and carbon monoxide detectors at the facility. The facility has central heating and air conditioning. Medications will be stored in a locked cabinet in Madrone 2 . *Continuation on Pages 2 and 3:*

SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Marilou Monico
LICENSING EVALUATOR SIGNATURE:	DATE: 05/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2023

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: EDUCARE CALIFORNIA AT SILICON VALLEY HEADSTART/INF	FACILITY NUMBER: 434417303
	VISIT DATE: 05/03/2023

NARRATIVE

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Renee and Reyna understand 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 is readily available for the children indoors via sippy cups and bottles. The facility will be providing snacks and meals to the children and will be catered to the center from Kidango's Kitchen located at 44000 Old Warms Springs Blvd., Fremont, CA 94538. There is also a kitchen at the facility located in between Madrone 2 and Madrone 3. The kitchen is equipped with refrigerator, microwave, dishwasher, sink with hot and cold running water and plenty of storage spaces.

There are 4 tables, 13 chairs, 12 cubbies, 8 cots, and 3 cribs available for the children. Renee ordered 3 high chairs during the inspection and proof of purchase was submitted. There is adequate supplies and toys for the infants.

The following are outdoor measurements and information:
Infant Playground: 46.167 x 35.333 = 1,631.218 minus 126.291 = 1,504.927
TOTAL PRESCHOOL OUTDOOR SPACE = 1,504.927 sq. ft. divided 75 sq. ft. = 20 children

LPAs observed that the playground is surrounded by appropriate fencing and the outdoor surfaces are safe. Shades are provided by trees. Drinking water outdoor is provided via sippy cups and bottles. No bodies of water were observed. The center has a working telephone which is (408) 573-4803. No transportation will be provided by the facility.

This facility plans to provide Incidental Medical Services – IMS. For IMS information, see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. A Plan of Operation that includes IMS was 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)/ (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.

Continuation on Page 3

SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Marilou Monico
LICENSING EVALUATOR SIGNATURE:	DATE: 05/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2023

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: EDUCARE CALIFORNIA AT SILICON VALLEY HEADSTART/INF	FACILITY NUMBER: 434417303
	VISIT DATE: 05/03/2023

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Fingerprint clearances for individuals working at the facility are issued by the Santa Clara Department of Education and do not come under the jurisdiction of Community Care Licensing Division.

LPAs discussed the safe sleep regulations with Renee and Reyna and discussed the Child Care Licensing Safe Sleep webpage athttps://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPAs informed Renee and Reyna 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 Renee 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 Renee Garcia, Supervisor Head Start Preschool Sites, and Reyna Dominguez, Early Head Start Program Manager. LPAs advised Renee and Reyna that a license for 8 infants will be submitted to Licensing Management for the final stage of approval.

SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Marilou Monico
LICENSING EVALUATOR SIGNATURE:	DATE: 05/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2023

LIC809 (FAS) - (06/04)

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