434417304-4-19-2024-07-CC-MKAR-D4GSLR-20240419135846

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434417304
Report Date: 04/19/2024
Date Signed: 04/19/2024 01:59:00 PM

Document Has Been Signed on 04/19/2024 01:59 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:	BUILDING KIDZ SANTA CLARA		FACILITY NUMBER:	434417304
ADMINISTRATOR:	MIAO LI		FACILITY TYPE:	850
ADDRESS:	1500 LOS PADRES BLVD #110,#111		TELEPHONE:	(408) 758-8804
CITY:	SANTA CLARA	STATE: CA	ZIP CODE:	95050
CAPACITY:	66	CENSUS: 23	DATE:	04/19/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	12:00 PM
MET WITH:	Ajanta Das and Miao Li		TIME COMPLETED:	02:20 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 Analyst (LPA), Mandeep Kaur and met with Site Director Ajanta Das and Owner, Miao Li for an unannounced Required - Annual/Random Inspection. The purpose of today's inspection was explained to Site Director and Owner. Facility's License, Notification of Parents’ Right Poster, Child Car Seat Law, Personal Rights (LIC 613A), Emergency Disaster Plan, Menus, Activity Schedule, and Earthquake Preparedness Checklist were observed to be posted. The preschool program has active waiver for outdoor space. The center's operating hours are Monday through Friday from 07:00 AM to 6:00 PM. The facility is licensed to serve 48 preschool children ages 2 to 6 years in Room D2 (Exploratorium) and Room D1 (Natureville) and 18 children in the Toddler option Ages 18 to 36 Months in Room U2 (Little Explorer). LPA toured the indoor and outdoor areas. LPA observed that the teacher-child ratio was in compliance. Fire drill was conducted on April 17, 2024. The facility has current children's roster and a copy was provided to LPA during the inspection. Cleaning products, disinfectants, sharp objects were stored inaccessible to children. Furniture and equipment were observed to be age appropriate and in good condition. The facility is clean. The bathrooms for children and staff are clean, sanitary, and operable. LPA observed five (5) toilets and four (4) sinks available for the Preschool children and two (2) sinks and two (2) toilets for Toddler Children. Site Director stated that the center has a third party cleaning service that comes and clean the facility after daycare hours. The center provides morning snacks, lunch, and afternoon snacks to the children. There is a kitchen at the facility for food preparation. The kitchen is equipped with refrigerators, stove, oven, microwave, dishwasher, storage space for food, and a sink with hot and cold running water. LPA observed 2% organic milk in the kitchen. Site Director stated that the facility serve 2% organic milk to children who are 2 years or older. Drinking water is available for the children indoor via pitchers and individual water bottles. LPA observed trash cans with tight fitting covers for the disposable of solid waste. *Continuation on next pages:*

SUPERVISOR'S NAME: Belinda Devall	TELEPHONE: (408) 598-5501
LICENSING EVALUATOR NAME: Mandeep Kaur	TELEPHONE: 408-334-8320
LICENSING EVALUATOR SIGNATURE:	DATE: 04/19/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/19/2024

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 CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: BUILDING KIDZ SANTA CLARA	FACILITY NUMBER: 434417304
	VISIT DATE: 04/19/2024

NARRATIVE

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The facility has fire extinguishers and working smoke and carbon monoxide detectors. LPA observed that the room temperature in Room D1(Natureville) was 61 degrees Fahrenheit. Owner adjusted the temperature to 68.8 degrees Fahrenheit during the inspection.

The playground is surrounded with appropriate fencing and the outdoor surfaces are safe. Shades in the Preschool Playground are provided by building overhang and sunshade sail. Drinking water is readily available for the children outdoor via pitchers and individual water bottles. LPA observed synthetic grass as resilient material under and around the slides structure in the Preschool Playground. There were no bodies of water observed. Site Director stated that there are no weapons or firearms on the premises.

LPA reviewed 3 random children's files. Children records reviewed include Admission Agreement,
Identification and Emergency Information, Consent for Emergency Medical Treatment, Physician's Report, TB test, Immunizations, Parent Right's Receipt, Personal Rights, and Health History.

LPA reviewed 6 staff files. Staff records reviewed include Employee Rights, Statement Acknowledging
Requirement to Report Child Abuse, Health Screening Report with TB Clearance, Immunizations (Measles,
Pertussis, and Influenza) and required training. Based on record reviews, 1 out of 6 of the staff is missing Mandated Reporter Training certificate. LPA reminded Site Director that the Mandated Reporter Training shall be completed within 90 days of hired date and renewed by all staff every two years. At least one staff member present during the inspection has current Pediatric CPR/First Aid certifications.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and
equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see
Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and
101226. 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/resources/child-care-centers/.

Continuation on next page:

SUPERVISOR'S NAME: Belinda Devall	TELEPHONE: (408) 598-5501
LICENSING EVALUATOR NAME: Mandeep Kaur	TELEPHONE: 408-334-8320
LICENSING EVALUATOR SIGNATURE:	DATE: 04/19/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/19/2024

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 CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: BUILDING KIDZ SANTA CLARA	FACILITY NUMBER: 434417304
	VISIT DATE: 04/19/2024

NARRATIVE

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Site Director, Ajanta Das, was reminded that all adults 18 and over, 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.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test.
For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP).
LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

LPA discussed and provided Site Director a copy of the Healthy Beverages in Child Care.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions
regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional
information regarding the inspection and its tools and methods, please visit the Program website at
www.cdss.ca.gov/inforesources/community-care-licensing/process.

As a result of this inspection, Type B deficiencies were cited on the following pages.

Exit interview conducted and report was reviewed with Site Director, Ajanta Das.

A NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 DAYS.

SUPERVISOR'S NAME: Belinda Devall	TELEPHONE: (408) 598-5501
LICENSING EVALUATOR NAME: Mandeep Kaur	TELEPHONE: 408-334-8320
LICENSING EVALUATOR SIGNATURE:	DATE: 04/19/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/19/2024

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 04/19/2024 01:59 PM - It Cannot Be Edited

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: BUILDING KIDZ SANTA CLARA	FACILITY NUMBER: 434417304
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 04/19/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101239(a)(1)(A)

Fixtures, Furniture, Equipment and Supplies

(A) In areas of extreme heat, the maximum shall be 20 degrees F (11.1 degrees C) less than the outside temperature. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on LPA observation, the temperature in Room D1 (Natureville) was 61 degrees Fahrenheit which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 04/19/2024
	Plan of Correction
1 2 3 4	Owner adjusted the temperature to 68.8 degrees Fahrenheit during the inspection. Deficiency corrected.

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in 1 out of 6 of the staff (Staff# 5) which poses potential health, safety or personal rights risk to persons in care.
	POC Due Date: 05/03/2024
	Plan of Correction
1 2 3 4	By POC date: 05/03/24, the center will submit the certificate of completion of the Mandated Reporter Training (AB1207).

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Belinda Devall	TELEPHONE: (408) 598-5501
LICENSING EVALUATOR NAME: Mandeep Kaur	TELEPHONE: 408-334-8320
LICENSING EVALUATOR SIGNATURE:	DATE: 04/19/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/19/2024

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 04/19/2024 01:59 PM - It Cannot Be Edited

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: BUILDING KIDZ SANTA CLARA	FACILITY NUMBER: 434417304
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 04/19/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.808(a)(1)

Beverages served by daycare providers to children - Whenever milk is served, serve only lowfat (1 percent) milk or nonfat milk to children two years of age or older. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on Site Director's statement and LPA observation, the licensee did not comply with the section cited above by serving 2% organic milk to children who are 2 years of age or older a which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 04/26/2024
	Plan of Correction
1 2 3 4	By POC Date: 04/26/24, Site Director states that she will submit a written plan to ensure that children 2 years and older will be served low-fat(1%) or non-fat milk.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Belinda Devall	TELEPHONE: (408) 598-5501
LICENSING EVALUATOR NAME: Mandeep Kaur	TELEPHONE: 408-334-8320
LICENSING EVALUATOR SIGNATURE:	DATE: 04/19/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/19/2024

LIC809 (FAS) - (06/04)

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