434412401-7-13-2023-07-CC-PHEZ-CTPRWK-20230713132315

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434412401
Report Date: 07/13/2023
Date Signed: 07/13/2023 01:23:20 PM

Document Has Been Signed on 07/13/2023 01:23 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-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME:	SCUTTLEBUGS CHILD DEVELOPMENT CENTER		FACILITY NUMBER:	434412401
ADMINISTRATOR:	LINDA WHITE		FACILITY TYPE:	850
ADDRESS:	3291 STEVENS CREEK BLVD		TELEPHONE:	(408) 564-5356
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95117
CAPACITY: 84	TOTAL ENROLLED CHILDREN: 84	CENSUS: 46	DATE:	07/13/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:11 AM
MET WITH:	Linda White		TIME COMPLETED:	11:00 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), Pete Hernandez, met with Center Director, Linda White for an unannounced Required 1 Year Inspection in the Preschool Program and explained the purpose of the visit. Normal business hours are Monday through Friday 7:00 AM to 6:00 PM. The facility has three waivers on file for shared indoor gym, shared restrooms and the outdoor playground space not to exceed 40 children at one time. LPA observed the required posted materials, including the Facility License, Emergency Disaster Plan (LIC 610), Earthquake Preparedness Checklist (LIC 9148), Parents' Rights Poster (PUB 393), Personal Rights (LIC 613A), Child Car Seat Law (PUB 269), Menus, and Activity Schedule. LPA observed (11) Preschoolers in Room 3 with three (2) Teachers. LPA observed (21) Preschoolers in Room 4 with three (2) Teachers and (1) Aid. (14) Preschoolers in Room 5 with (2) Teachers. Teacher / Child ratio was observed during the inspection. LPA toured the indoor and outdoor areas of the Facility during today's inspection. LPA observed that all rooms are clean and safe for all children and staff. Mrs White states that the facility has an outside janitorial company that clean the facility Monday through Friday in the evenings. Drinking water is readily available for the children in each room and in the outdoor playground area via water pitchers and disposable cups or personal bottles. LPA observed solid waste containers with tight-fitting lids in each room. Staff and children's bathrooms are clean, sanitary, and operable. There is a separate staff bathroom not utilized by the children which an isolated child can use if needed. Mrs. White states that there are no weapons or firearms on the premises. REPORT CONTINUED ON THE FOLLOWING PAGE (PAGE #2 - REPORT DATED 07/13/2023):

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Pietro Hernandez
LICENSING EVALUATOR SIGNATURE:	DATE: 07/13/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2023

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
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: SCUTTLEBUGS CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 434412401
	VISIT DATE: 07/13/2023

NARRATIVE

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CONTINUATION OF PREVIOUS PAGE (PAGE #1 - REPORT DATED 07/13/2023):

The facility provides AM and PM snacks plus breakfast and lunch. Storage areas are clean, free of litter & rubbish, and free of rodents and other vermin. All food and beverages that require refrigeration are stored in covered containers at 45 degrees F or less. Cleaning supplies are inaccessible to the children. Any medications at the Facility are stored in the classroom and are inaccessible to children in care.

LPA reviewed 6 staff files during today's inspection. A review of staff records on July 13, 2023 indicates that all individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. LPA reminded the Center Director of the applicable civil penalties for those adults who have not received fingerprint clearances, are not associated to the license and who come in contact with or provide care and supervision to the children. Penalty amounts: $100.00 per person per day, minimum of $100.00 to a maximum of $500.00 per person for an initial violation and a minimum of $100.00 to a maximum of $3000.00 per person for any subsequent violations within a 12-month period. All teacher files reviewed contain the required transcripts/verification of experience. Director White understands the conditions, limitations, and capacity specifications of the Facility license. Director White understands that children shall be visually supervised at all times. And that a teacher or aide is required to be present in the nap room any time a child is placed in the room.

LPA observed all furniture and equipment indoors is in good condition and safe for the children. The playground areas utilized by children is surrounded by appropriate fencing and the outdoor surfaces are safe for the children. LPA observed that the outdoor equipment is age appropriate and in good condition. There is sufficient resilient material on the outdoor playground areas. LPA did not observe any bodies of water.

LPA obtained a copy of an updated Facility Roster.

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Pietro Hernandez
LICENSING EVALUATOR SIGNATURE:	DATE: 07/13/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2023

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
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: SCUTTLEBUGS CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 434412401
	VISIT DATE: 07/13/2023

NARRATIVE

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CONTINUATION OF PREVIOUS PAGE (PAGE #2 - REPORT DATED 07/13/2023):

Last fire drill was done 6/15/2023 . LPA informed Licensee that fire/disaster drills must be practiced at least once every six months and documented. Licensee is compliant.

Director White and all preschool staff have current Mandated Reporter certificates.

Director Linda White has current CPR and First Aid Certificate. Linda's expires on 8/21/23. At least one staff member on site has a current CPR and First Aid certification on file. Mrs White understands that there shall be at least one person, with valid CPR and First Aid certifications, on site.

LPA reviewed the files of 10 children and they all contained the required documentation.

LPA reviewed the files of 6 staff and all the files contained the required documentation.

Should there ever be issuance of Type A citations today, a copy of the Facility Evaluation Report LIC809 has to be posted on the wall and a copy to be given to all parents of currently and newly enrolled children for next 12 months. In addition, copy of LIC9224 Statement Acknowledging Receipt of Licensing Reports need to be signed and kept in child files.

A deficiency is not being cited based on the LPA observation, interviews conducted, and record review in accordance with the California Code of Regulations, Title 22. An exit interview was conducted, and Plan of Corrections were reviewed and developed with the licensee. A copy of this report and appeals rights were discussed and left with the Licensee, Linda White, whose signature on this form confirm receipt of these documents.

A NOTICE OF SITE VISIT WAS ISSUED, POSTED NEAR THE ENTRANCE TO THE FACILITY, AND MUST REMAIN POSTED FOR 30 DAYS.

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Pietro Hernandez
LICENSING EVALUATOR SIGNATURE:	DATE: 07/13/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2023

LIC809 (FAS) - (06/04)

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