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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434400313
Report Date: 04/28/2023
Date Signed: 04/28/2023 02:27:08 PM


Document Has Been Signed on 04/28/2023 02:27 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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131



FACILITY NAME:BRIGHT HORIZONS-SAN JOSEFACILITY NUMBER:
434400313
ADMINISTRATOR:REBECCA ADAMSFACILITY TYPE:
850
ADDRESS:6120 LISKA LANETELEPHONE:
(408) 225-3276
CITY:SAN JOSESTATE: CAZIP CODE:
95119
CAPACITY:84CENSUS: 37DATE:
04/28/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Claire BradyTIME COMPLETED:
02:45 PM
NARRATIVE
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Licensing Program Analyst (LPA), Janette Cruz, met with Claire Brady, Director, for an unannounced case management inspection in response to a self-reported Unusual Incident that the Facility reported to the Department. LPA observed that the teacher/child ratio was in compliance during today's inspection.

Per Unusual Incident Report submitted by Regional Manager, Shelley Gonzales, incident occurred on 03/31/2023 when preschool child (C1) wandered away from the group of children gathered at the playground and was found unattended approximately for a minute, sitting on a couch inside the Two's -1 classroom.

Claire stated that she was not present during that morning of the incident reported on 3/31/2023. Claire stated that there were 12 full-time preschool children with two teachers (S1 and S2) supervising at the playground at the time of the incident at 10:25AM. Claire stated that it was staff/cook, S3, who found C1 unattended in the Two's 1 classroom.

LPA conducted additional staff interviews of the three staff who were present and who were witness to the incident. Claire stated that a tracking app via IPad is being used by the teachers to check children's headcount. LPA obtained a copy of the tracking form generated from the IPad, of children's headcount for the week covering the day of incident. Claire stated that there were loud sounds from the repairs being done on the Two- 1 classroom door that caused children to be scared, curious and excited. S1 and S2 who were supervising the children were trying to move children to the sand box area of the playground away from the door being repaired, when C1 was left unaccounted for.
SUPERVISOR'S NAME: Diana StephensonTELEPHONE: (408) 324-2128
LICENSING EVALUATOR NAME: Janette CruzTELEPHONE: (408) 334-8312
LICENSING EVALUATOR SIGNATURE:
DATE: 04/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/28/2023
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


Document Has Been Signed on 04/28/2023 02:27 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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131


FACILITY NAME: BRIGHT HORIZONS-SAN JOSE
FACILITY NUMBER: 434400313

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/28/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/01/2023
Section Cited

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101229 (a)(1)Care and Supervision. No child(ren) shall be left without the supervision, including visual observation, of a teacher at any time except as specified in sections 101216.2(e)(1) and 101230(c)(1). This requirement was not met as evidenced by:
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 Director agreed to submit a written Plan of Correction (POC) to LPA Cruz indicating what steps will be implemented to ensure that the preschool children are supervised at all times, including transition times by POC date 05/01/23 . Civil penalty was assessed and LIC 421M was given to Directors during today's visit .
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Based on observation, interviews and record reviews, a preschool child, C1, was left unattended and wandered into a classroom for about a minute on 3/31/23. This poses an immediate threat to health and safety of children in care.
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According to AB 633, parents must be provided with this report which contains this Type A deficiency for the next 12 months and copy of signed acknowledgement form must be kept in each child's file.

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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: Diana StephensonTELEPHONE: (408) 324-2128
LICENSING EVALUATOR NAME: Janette CruzTELEPHONE: (408) 334-8312
LICENSING EVALUATOR SIGNATURE:
DATE: 04/28/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/28/2023
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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: BRIGHT HORIZONS-SAN JOSE
FACILITY NUMBER: 434400313
VISIT DATE: 04/28/2023
NARRATIVE
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Claire stated that the C1 was unharmed and doing fine. Claire stated that she notified C1's parents regarding the incident on 4/4/23. Claire stated that she notified Regional Manager, Shelley Gonzales about the incident on 3/31/23 . Claire stated that a staff training about the incident and on the following topics : Transition Tracking, No Child Left Behind and Supervision was conducted on 4/11/23 and 4/13/23 . LPA obtained staff training documents conducted on 4/11/23 and 4/13/23. Claire stated that no non-emergency repairs will take place while children are present to avoid distractions and ensure adequate child supervision.

A deficiency was cited with civil penalty, appeal rights also given. See (809-D). Exit interview was conducted with Claire Brady, Director .

A Notice of Site Visit was issued and must be posted for 30 days.
SUPERVISOR'S NAME: Diana StephensonTELEPHONE: (408) 324-2128
LICENSING EVALUATOR NAME: Janette CruzTELEPHONE: (408) 334-8312
LICENSING EVALUATOR SIGNATURE:

DATE: 04/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2023
LIC809 (FAS) - (06/04)
Page: 3 of 3