434418499-4-8-2026-07-CC-JCRZ-DSXNHP-20260408102905

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434418499
Report Date: 04/08/2026
Date Signed: 04/08/2026 10:29:19 AM

Document Has Been Signed on 04/08/2026 10:29 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:	LOTUS PRESCHOOL		FACILITY NUMBER:	434418499
ADMINISTRATOR/ DIRECTOR:	LYNNE YAMAICHI		FACILITY TYPE:	860
ADDRESS:	632 NORTH FIFTH STREET		TELEPHONE:	(408) 293-1612
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95112
CAPACITY: 24	TOTAL ENROLLED CHILDREN: 24	CENSUS: 0	DATE:	04/08/2026
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	08:37 AM
MET WITH:	Lynne Yamaichi		TIME VISIT/ INSPECTION COMPLETED:	11:00 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 04/08/2026, Licensing Program Analyst (LPA) Janette Cruz met with Lynne Yamaichi, Applicant Representative. Also present during today's inspection are Alyson Yamaichi (Director), Leslie Kitazumi (Office Manager) and Lisa Tsuchitani (Board director-Betsuin Church). 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. Applicant requested for a change of location of preschool license with capacity of 24 children ages 2-5 years. The facility has an existing licensed preschool program Facility#430709268. The child care center will operate from Monday–Friday 7:30AM to 5:30PM. Facility is located in an annex building of a church site, San Jose Buddhist Betsuin. The fire clearance was approved by San Jose Fire Department on April 01, 2026. . LPA toured and measured the on-limits areas and classrooms located at the facility. The facility has a total of one classroom that is to be divided into two preschool age groups. Preschool Classroom measurements are: The Indoor total measurements contain a total of {1205.67} square feet, which will accommodate Applicant's request for 24 preschool children. Preschool Outdoor Play measurements are: Outdoor total measurements contain a total of {2866.75 square feet), which will accommodate Applicant’s request for 24 preschool children. Indoor/Children's Area LPA observed the preschool classroom to be clean, safe, sanitary, and in good repair. All indoor and outdoor passageways, as well as other areas of potential hazard, were free of obstruction. A comfortable temperature was maintained for children at all times. Furniture and equipment were in good condition, free of sharp, loose, or pointed parts. All materials and surfaces accessible to children, including toys, were free of toxic substances. Play equipment and materials were observed to be age-appropriate. Tables and chairs were suitable to meet the needs of the children.

NAME OF LICENSING PROGRAM MANAGER: Deborah Lowe
NAME OF LICENSING PROGRAM ANALYST: Janette Cruz
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 04/08/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/08/2026

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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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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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: LOTUS PRESCHOOL	FACILITY NUMBER: 434418499
	VISIT DATE: 04/08/2026

NARRATIVE

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The following equipment and fixtures are available for preschool children: 24 chairs, 4 tables, 20 cots,
4 mats,, 24 cubbies, 4 toilets, and 4 sinks. Staff have a designated bathroom separate from the children's restrooms, which may also be used for sick children if needed. LPA observed that the facility's office and staff bathroom are located on the second floor of the building. The second floor may be accessed via stairs or elevator. LPA observed a retractable gate at the stairs and a cover placed over the elevator controls to prevent children from accessing the second floor. LPA also observed a gym space, which applicant stated will be used as an activity area and may serve as an alternative outdoor space during inclement weather conditions,
LPA observed first aid supplies, medications, and cleaning products are stored in cabinets and high areas, out of children’s reach. LPA observed containers with tight-fitting lids available for the disposal of solid wastes. LPA observed fully charged fire extinguisher, smoke and carbon monoxide detectors at the facility. Storage areas for poisons shall be locked. LPA advised that Applicant maintains first-aid supplies in a location accessible to staff but inaccessible to children.

Snacks are prepared on site, and parents provide lunch for their children. The applicant was reminded that full-day programs must ensure each child has a lunch and that children must have access to drinking water at all times. Drinking water is readily available indoors through a water fountain from a filtered source, and children may bring their own water bottles outdoors. Sink faucets accessible to children provide only cold running water.

LPA observed the kitchen area to be clean and free of litter and rubbish. Kitchen is equipped with refrigerator and microwave. The applicant was advised that appropriate measures must be taken to keep the kitchen free of rodents and other vermin.

The outdoor areas for preschool children were observed to be free of hazards, including holes, broken glass, dry grasses, and other debris that could pose a fire or safety risk. Shade is provided by canopy structures. LPA observed no climbing equipment. The playground is enclosed by a fence at least four feet high to ensure children remain safely within the outdoor activity area. Any construction or equipment that could pose a hazard in the outdoor activity area must be made inaccessible to children in care. LPA observed no bodies of water. The applicant stated that there are no weapons on the premises. The facility does not provide transportation to children.

NAME OF LICENSING PROGRAM MANAGER: Deborah Lowe
NAME OF LICENSING PROGRAM ANALYST: Janette Cruz
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 04/08/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/08/2026

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: LOTUS PRESCHOOL	FACILITY NUMBER: 434418499
	VISIT DATE: 04/08/2026

NARRATIVE

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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.

LPA discussed the safe sleep regulations with Applicant 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. LPA 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.

NAME OF LICENSING PROGRAM MANAGER: Deborah Lowe
NAME OF LICENSING PROGRAM ANALYST: Janette Cruz
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 04/08/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/08/2026

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: LOTUS PRESCHOOL	FACILITY NUMBER: 434418499
	VISIT DATE: 04/08/2026

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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 exit interview was conducted and copy of appeal rights were provided to Lynne Yamaichi, Applicant Representative. Final license determination for a single license will be made upon review by the Licensing Program Manager

NAME OF LICENSING PROGRAM MANAGER: Deborah Lowe
NAME OF LICENSING PROGRAM ANALYST: Janette Cruz
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 04/08/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/08/2026

LIC809 (FAS) - (06/04)

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