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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434416363
Report Date: 03/03/2022
Date Signed: 03/14/2022 09:05:13 AM

Document Has Been Signed on 03/14/2022 09:05 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:BRIGHT SUNRISE PRESCHOOL EVERGREENFACILITY NUMBER:
434416363
ADMINISTRATOR:LOC KERWINFACILITY TYPE:
850
ADDRESS:3520 SAN FELIPE ROADTELEPHONE:
4085618634
CITY:SAN JOSESTATE: CAZIP CODE:
95135
CAPACITY: 60TOTAL ENROLLED CHILDREN: 60CENSUS: 13DATE:
03/03/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Loc KerwinTIME COMPLETED:
04:30 PM
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Licensing Program Analysts (LPAs) Dung Mac and Stephanie Collins, conducted an announced pre-licensing inspection to the facility today. LPAs met with Loc Kerwin, Applicant/Site Director. The purpose of today's inspection: change of ownership (corporate status) and name change of the facility. The existing facility is under the corporate & facility name - Genius Kids Preschool & Daycare of Evergreen San Jose (facility #434415506).

The Applicant is applying for a license to serve 60 children ages 2-5 years old. Present were 13 children and 4 staff. The Facility is located on the premises of the Evergreen Valley United Methodist Church and will be using Rooms 1, 2, 3 & 4. The facility will operate Monday through Friday from 8:00AM to 6:00PM.

LPAs toured and measured the indoor and outdoor areas of the facility during today's inspection.

INDOOR MEASUREMENTS ARE AS FOLLOWS:

Room 1 = 23.5 x 25.2 = 592.20 minus 36.63 (encumbered space) = 555.57
Room 2 = 23.4 x 25.2 = 589.68 minus 42.34 (encumbered space) = 547.34
Room 3 = 23.7 x 25.1 = 594.87 minus 45.40 (encumbered space) = 549.47
Room 4 = 23.4 x 25.8 = 603.72 minus 145.40 (encumbered space) = 458.32

TOTAL = 2,110.70 sq. ft. divided 35 sq. ft. = 60 children

There are 8 sinks (120), 4 (60) toilets, and 1 urinal (15) available for children to use. Loc states that the sinks used by children only have cold running water. There are 14 tables, 70 mats, 65 chairs, and 154 cubbies. LPAs observed container with tight-fitting lid for solid waste in each classroom. All classrooms have appropriate lighting. Drinking water is readily available for the children indoors via water fountain and individual bottle of water.

Report To Be Continued on Page #2
SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Dung Mac
LICENSING EVALUATOR SIGNATURE: DATE: 03/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/03/2022
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: BRIGHT SUNRISE PRESCHOOL EVERGREEN
FACILITY NUMBER: 434416363
VISIT DATE: 03/03/2022
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LPAs observed functioning smoke/carbon monoxide detectors at the facility. LPAs observed cleaning supplies are stored on high shelves inaccessible to children in each classroom. First aid supplies are stored inaccessible to children in each classroom. There is adequate equipment, supplies, and toys for the children. The facility has a separate staff bathroom located in Room 3 that will be utilized by sick children if necessary. Sick children will be isolated in the office and isolation equipment will be provided.

The facility will be providing AM/PM snacks. Children will bring their own lunch. Lunch will be provided per parent's request. The food preparation area is clean, and has sink, microwave, refrigerator, air fryer, and storage space for food. Paper utensils and plates will be utilized by the Facility. Transportation will not be provided.

OUTDOOR MEASUREMENTS:

Playground = 62.3 x 81.2 = 5,058.76
Bicycle Area = 33.4 x 10.6 = 354.04

TOTAL OUTDOOR SPACE = 5,412.80sq. ft. divided by 75 sq. ft. = 72 children

The playground area utilized by children is surrounded by appropriate fencing. LPAs observed that the areas around and under the climbing structures are cushioning with wood chips as resilient material. The outdoor equipment is age appropriate. Shade is provided by umbrella and building overhangs. Drinking water is readily available for the children outdoors via water fountain and individual bottle of water. LPAs observed no bodies of water.

Loc Kerwin, Applicant/Site Director, has obtained a Criminal Records Clearance and Child Abuse Index Checks. Site Director’s Pediatric First Aid/CPR Certifications expire May 8, 2023. Director has proof of completion of Preventative Health Practices and immunization in Measles and Pertussis and Influenza on file.

Report To Be Continued on Page #3
SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Dung Mac
LICENSING EVALUATOR SIGNATURE:

DATE: 03/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2022
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: BRIGHT SUNRISE PRESCHOOL EVERGREEN
FACILITY NUMBER: 434416363
VISIT DATE: 03/03/2022
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Applicant, Loc Kerwin, was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPAs reviewed with the Applicant the LIC 311A, Records To Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted.

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)/ (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. Plan of Operation that includes IMS was received during today's inspection.



PIN 22-02-CCP - Best Practices Related to the Provision of Incidental Medical Services in Child Care Center and Family Care Homes was provided to Applicant.

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 the Applicant, Loc Kerwin. Applicant was advised that a license for 60 preschool children will be approved pending Licensing Management review and approval.
SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Dung Mac
LICENSING EVALUATOR SIGNATURE:

DATE: 03/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2022
LIC809 (FAS) - (06/04)
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