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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434417100
Report Date: 12/18/2023
Date Signed: 12/18/2023 10:26:16 AM

Document Has Been Signed on 12/18/2023 10:26 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: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: 25TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
12/18/2023
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Jamie FergusonTIME COMPLETED:
10:45 AM
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Licensing Program Analysts (LPA’s) Jessica Bongardt and Anna Morales conducted an Announced Case Management, Licensee initiated. LPA's met with Director, Jamie Ferguson, and the purpose of the inspection was explained. The applicant is reactivating their preschool license to serve, 2 years to 6 years old, for a maximum of 25 children. The preschool program plans to operate: Monday through Friday from 7:00 AM to 6:00 PM. The San Jose Child Care Regional Office received a fire clearance from the San Jose Fire Department (SJFD) on 08/10/2023. SJFD approved use of indoor and outdoor areas for preschool age children.

LPA's toured the facility both inside and out. LPA's saw the required posted material including Emergency Disaster Plan (LIC610), Earthquake Preparedness Checklist (LIC 9148), Parents’ Rights Poster (PUB 393), Car Seat Law (PUB 269) Snack Menu, and Activity Schedule.

The Director understands that the children shall be visually supervised at all time within the classroom and in the playground areas. Any child(ren) who exhibit symptoms of illness including, but not limited to, fever or vomiting, are not accepted into care. Any child(ren) who become ill during the day will be isolated in the Director's Office and isolation equipment will be provided. Sick children will use the staff bathroom if needed.

Staff and children’s bathrooms are clean, sanitary, and operable. There is a staff bathroom located near Area 6 that also acts as storage for cleaning supplies. LPA's observed containers with tight-fitting lids for the disposal of solid waste. Two fire extinguishers (3-A-40-BC) were observed. LPA's observed smoke/carbon monoxide detectors and appropriate lighting in each classroom. The facility has central heating and a window unit for air conditioning. Director understands that smoking is not allowed on the premises.

LPA's observed all furniture and equipment is in good condition and safe for the children. There is adequate equipment, supplies, and toys for the preschool children in each classroom. The Director understands that the facility must be kept free of flies, other insects & rodents. 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.

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Jessica Bongardt
LICENSING EVALUATOR SIGNATURE: DATE: 12/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/18/2023
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 CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: ACTION DAY NURSERIES & PRIMARY PLUS INC
FACILITY NUMBER: 434417100
VISIT DATE: 12/18/2023
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Shade in the yard is provided by trees. The areas under and around the play structure is cushioned with resilient material (sand) that will absorb a fall. 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.

Director, 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, 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.

Exit interview conducted and report was reviewed with Jamie Ferguson, Director. License will be active once approved by program manager.

Notice of site visit was given and must be posted for 30 days.

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Jessica Bongardt
LICENSING EVALUATOR SIGNATURE:

DATE: 12/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2023
LIC809 (FAS) - (06/04)
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