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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434417100
Report Date: 07/28/2023
Date Signed: 07/28/2023 11:40:26 AM

Document Has Been Signed on 07/28/2023 11:40 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-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:ACTION DAY NURSERIES & PRIMARY PLUS INCFACILITY NUMBER:
434417100
ADMINISTRATOR:JAMIE FERGUSONFACILITY TYPE:
850
ADDRESS:2021 LINCOLN AVENUETELEPHONE:
(408) 244-1968
CITY:SAN JOSESTATE: CAZIP CODE:
95125
CAPACITY: 27TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
07/28/2023
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
08:20 AM
MET WITH:Jenna Valadao & Jamie FergusonTIME COMPLETED:
11:55 AM
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Licensing Program Analysts (LPA’s) Kassandra Medrano and Marilou Monico conducted a Prelicensing Inspection. LPAs met with Facility Representatives, Jenna Valadao and Jamie Ferguson, and the purpose of the inspection was explained. The applicant is applying for a preschool license, 2 years to 6 years old, for 27 children. The preschool program plans to operate: Monday through Friday from 7:00 AM to 6:00 PM. LPAs toured the facility both inside and out, as well as measured the indoor and outdoor space during today's visit. The San Jose Child Care Regional Office received a fire clearance from the San Jose Fire Department (SJFD) on 07/20/2023. SJFD approved use of indoor and outdoor areas for preschool age children.
Indoor Activity Space:
AREA 1: 16.333 x 14.500 = 236.828 minus 21.469 (encumbered space) = 215.359
AREA 2: 10.333 x 9.750 = 100.746 minus 9.682 (encumbered space) = 91.064
AREA 3: 15.250 x 12.000 = 183.00
AREA 4: 14.583 x 12.000= 174.996
AREA 5: 10.167 x 9.000 = 91.503 minus 10.081 (encumbered space) = 81.422
AREA 6: 11.667 x 14.417 = 168.203 minus 35.793 (encumbered space) = 132.41
TOTAL INDOOR SPACE = 878.251 sq. ft. divided by 35 = 25 children

Facility has 3 (45) sinks, 3 (45) toilets available for the children. The sinks used by children only have cold running water. There is a staff bathroom located near Area 6 that also acts as storage for cleaning supplies. The isolation of sick children will be in the Director's Office and isolation equipment will be provided. Sick children will use the staff bathroom if needed.LPAs observed containers with tight-fitting lids for the disposal of solid waste. LPAs observed smoke/carbon monoxide detectors and appropriate lighting in each classroom. The facility has central heating and window unit for air conditioning.

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SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Kassandra Medrano
LICENSING EVALUATOR SIGNATURE: DATE: 07/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/28/2023
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
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: ACTION DAY NURSERIES & PRIMARY PLUS INC
FACILITY NUMBER: 434417100
VISIT DATE: 07/28/2023
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 LPAs observed the heating vents that blow out hot air in activity room 1 and 2 are hot to the touch when functioning. Medications will be out of reach of children. Facility representatives understand that the facility must be kept free of flies, other insects & rodents. LPAs observed that all furniture and equipment indoors are in good condition and safe for the children. Drinking water will be readily available for the children indoors via filtered water jugs and individual cups or bottles. Transportation will not be provided by the facility. The facility will serve morning and afternoon dry snacks. Facility will provide the option for families to receive catered meals prepared by “Michelle’s Luncheon.” The kitchen is equipped with cold running water, and storage space for food. Disposable utensils and plates will be utilized by the facility.

There are 6 indoor children’s tables, 5 outdoor children’s tables with benches attached, 40 chairs, 31 cubbies, and 27 cots for the children. There is adequate equipment, supplies, and toys for the preschool children in each classroom.

OUTDOOR MEASUREMENTS:
PRESCHOOL PLAYGROUND: 52.833 x 66.000 = 3,486.978
52.167 x 14.250 = 743.379
TOTAL OUTDOOR SPACE = 4,230.357 sq. ft. divided by 75 = 56 children
LPAs observed the playground is fully fenced and did not meet the height requirements, as it measures under 4 feet. Shade in yard is provided by trees. The areas under and around the play structure is cushioned with resilient material (sand) that will absorb a fall. Drinking water will be provided via filtered water jugs and individual cups or bottles .No bodies of water were observed. “Garden” can be used as activity space, as for pavement outside of fencing that cannot be used by children. Facility representatives were reminded that initial lead testing results shall be received and posted within 180 days from licensure. Following the initial testing facility must conduct water testing every 5 years based on initial test date. 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) tollfree 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.

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SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Kassandra Medrano
LICENSING EVALUATOR SIGNATURE:

DATE: 07/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/28/2023
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: ACTION DAY NURSERIES & PRIMARY PLUS INC
FACILITY NUMBER: 434417100
VISIT DATE: 07/28/2023
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Facility representatives were 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.

LPAs reviewed with Applicant Representative the LIC 311A, Records to Be Maintained at The Facility, for child’s records, personnel records, administrative records, and documents to be posted. Facility representatives were informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and resource and referral agencies (R&R) throughout California.

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.

LPAs advised Jenna and Jamie that a license for 25 Preschool children will be submitted to Licensing Management for the final stage of approval upon receiving the following items:

1) Documentation of barricaded heating vents in Areas 1 & 2


2) Outside fence surrounding yard measured under 4 feet. Submit photos showing fence is at least 4 feet high.
3) receipt of items missing from notice of incomplete application that was sent 7/25/2023

Exit interview conducted and report was reviewed with Jenna Valado and Jamie Ferguson, Facility Representatives.

SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Kassandra Medrano
LICENSING EVALUATOR SIGNATURE:

DATE: 07/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/28/2023
LIC809 (FAS) - (06/04)
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