274410830-6-8-2023-07-CC-FCJO-CSLQR8-20230608122331

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 274410830
Report Date: 06/08/2023
Date Signed: 06/08/2023 12:23:38 PM

Document Has Been Signed on 06/08/2023 12:23 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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME:	MAOF TANIMURA & ANTLE EARLY LEARNING CENTER		FACILITY NUMBER:	274410830
ADMINISTRATOR:	ANNA MARIA CONTRERAS		FACILITY TYPE:	850
ADDRESS:	121 SPRECKELS BLVD		TELEPHONE:	(323) 890-9600
CITY:	SPRECKELS	STATE: CA	ZIP CODE:	93962
CAPACITY:	24	CENSUS: 13	DATE:	06/08/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:50 AM
MET WITH:	Anna M Contreras		TIME COMPLETED:	11:00 AM

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) Fermin Campos-Jaramillo met with Site Director Anna M Contreras, for an unannounced required Inspection. LPA toured the indoor and outdoor areas of the Facility during today's inspection. 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), Menu, Activity Schedule, and Waivers. Days and hours of operation are Monday through Friday 4:30 am to 5:30 PM. The Facility is licensed to serve a maximum of forty eight 24 children ages 2-5 years. LPA reviewed ten children's and four staff files during today's inspection. Each child's file reviewed contains the required documents; including the Information and Emergency Information form (LIC 700) and immunization records. All staff files reviewed contain the required documents; including transcripts/verification of experience/immunization records, and Health Screening Report. All the staff have current certificates of completion of the Mandated Reporter Training for Child Care Workers on file. Last fire/disaster drill was documented on 5/22/23. All staff have current CPR and First Aid certifications on file. Site Director understands that there shall be at least one person, with valid CPR and First Aid certifications, on site at all times or present during off-site activities (field trips). LPA observed that the teacher/child ratio was in compliance during today's inspection. Site Director understands the conditions, limitations, and capacity specifications of the Facility. Report dated 6/08/23 continues on page 2

SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Fermin Campos-Jaramillo	TELEPHONE: 408-334-8557
LICENSING EVALUATOR SIGNATURE:	DATE: 06/08/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/08/2023

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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: MAOF TANIMURA & ANTLE EARLY LEARNING CENTER	FACILITY NUMBER: 274410830
	VISIT DATE: 06/08/2023

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
26
27
28
29
30
31
32

***************Report dated 6/08/23 continues from page 1.
Site Director understands that children shall be visually supervised at all times. Any child(ren) who exhibit symptoms of illness including, but not limited to, fever or vomiting, are not accepted in care. Any child(ren) who become ill during the day, shall be isolated by the library area in the classroom.
LPA observed that the Facility is clean, safe, sanitary, and in good repair for children, staff, and visitors. The Facility has adequate ventilation, including central air conditioning/heating. Director states that the corporate office provides janitorial services every other day to the Center. Site Director understand that the Facility must be kept free of flies and other insects & rodents.

LPA observed that all furniture and equipment is in good condition and safe for the children.
Drinking water is readily available for the children in the Facility (indoor/outdoor) via water dispenser and disposable cups. Staff and children's bathrooms are clean, sanitary, and operable. Site Director states that there are no weapons or firearms on the premises. The Facility has functioning carbon monoxide detectors.
The Facility provides full lunch meals which are prepared at the center's kitchen. The Facility has trash cans with tight fitting lids for solid waste. Cleaning supplies are inaccessible to the children and stored inaccessible to children. Site Director states that there are no poisons in the Facility. LPA observed a complete First Aid kit in the Facility. Site Director states that the Facility does not administer any medications at this time. Site Director understands that smoking is not allowed on the Facility premises.
For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated 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

Report dated 6/08/23 continues on page 3.

SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Fermin Campos-Jaramillo	TELEPHONE: 408-334-8557
LICENSING EVALUATOR SIGNATURE:	DATE: 06/08/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/08/2023

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: MAOF TANIMURA & ANTLE EARLY LEARNING CENTER	FACILITY NUMBER: 274410830
	VISIT DATE: 06/08/2023

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
26
27
28
29
30
31
32

Report dated 6/08/23 continues from page 2.

The playground area 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 a secure play structure that is age appropriate for the preschool children. There sand as cushioning material under and surrounding the play structure. Shade is provided by a tarp and a tree. LPA did not observe any bodies of water. Site Director states that the Facility does not provide transportation.

A review of staff records on 6/06/23 indicates that all Facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. Site Director was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in the 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.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

Exit interview conducted and report was reviewed with Site Director Anna M Contreras.

No deficiencies were cited today.

A notice of site visit was printed and handed to Site Director to post visible to parents, and must remain posted for 30 days.

SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Fermin Campos-Jaramillo	TELEPHONE: 408-334-8557
LICENSING EVALUATOR SIGNATURE:	DATE: 06/08/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/08/2023

LIC809 (FAS) - (06/04)

Page: 3 of 3