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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 430700524
Report Date: 10/11/2021
Date Signed: 10/26/2021 12:52:28 PM

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:PRESBYTERIAN EARLY LEARNING CENTERFACILITY NUMBER:
430700524
ADMINISTRATOR:RANDLE, GRACEFACILITY TYPE:
850
ADDRESS:728 WEST FREMONT AVENUETELEPHONE:
4082452253
CITY:SUNNYVALESTATE: CAZIP CODE:
94087
CAPACITY:155CENSUS: 55DATE:
10/11/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Darlene Ogasawara TIME COMPLETED:
03:52 PM
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Licensing Program Analyst (LPA) Stephanie Collins conducted an unannounced Annual inspection and the facilities request to decrease capacity from 155 to 145 and discontinuing use of room 904 as preschool room square footage from the preschool’s licensed . LPA met with Assistant Director Darlene Ogasawara and informed them the purpose of the visit. Preschool representative stated no structural change have occurred since last evaluation report In 2019 . Facility's License, Notification of Parents’ Right Poster, Children's Personal Rights, and Child Car Seat Law were observed to be posted. Operating days and hours are Monday-Friday 07:30 AM to 5:00 PM. The following rooms will remain in serve for the preschool program license. Fire clearance for 145 children was granted on August 8 , 2020 .

Room 301: 32.664 x 17.83 = 582.399 minus 99.538 (encumbered space) = 482.861
Room 501: 43.581 x 29.913 = 1303.638
Room 503: 27.498 x 27.000 = 724.446 minus 42.438 (encumbered space) = 682.008
Room 505: 27.498 x 27.000 = 724.446 minus 135.199 (encumbered space) = 589.247
Room 506: 27.581 x 27.083 = 746.976 minus 33.201 (encumbered space) = 713.775
Room 801: 31.664 x 29.415 = 931.396 minus 57.524 (encumbered space) = 873.872
Room 802: 29.332 x 31.581 = 926.333 minus 21.852 (encumbered space) = 904.481
Room 901: 29.581 x 15.664 = 463.356 minus 37.037(encumbered space) = 426.319
(Measurement taken from Evaluation Report dated 01/10/2013)

TOTAL PRESCHOOL INDOOR SPACE = 5,976. 201 sq. ft divided by 35 sq. ft. = 170 children

LPA observed 18 sinks (270) and 13 toilets (195) available for the children.
SUPERVISOR'S NAME: Sandy KnightTELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Stephanie CollinsTELEPHONE: (408) 334-8555
LICENSING EVALUATOR SIGNATURE:

DATE: 10/11/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2021
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 4
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: PRESBYTERIAN EARLY LEARNING CENTER
FACILITY NUMBER: 430700524
VISIT DATE: 10/11/2021
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PRESCHOOL PLAYGROUND:
(Evaluation Report dated 01/10/2013)
Playground 1: 158.498 x 45.415 = 7198.187 minus 308.163 (encumbered space) = 6890.024
Playground 2: 91.747 x 55.000 = 5046.085 minus 8.445 (encumbered space) = 5037.640
Playground 3: 48.83 x 89.498 = 4370.187

TOTAL PRESCHOOL OUTDOOR SPACE = 16297.851 divided by 75 = 217 children

The preschool program has three playgrounds. Shade is provided by trees, canopies, and building overhang. LPA observed an outdoor patio in playground 1. There are climbing structures in all three yards with tanbarks as resilient material.

Facility was observed to be in compliance with teacher to child ratio requirement during inspection. LPA inspected the building inside and out with Darlene Ogasawara. The Preschool is located on a Church site and operates in Rooms: 301, 501- 506, 801, 802, 901, and 904. The Preschool classrooms (#301 None operative at this time), #503, #505, #506, #801, #802, #901, restrooms, Office (#502), Storage Room (#504) and food preparation areas were inspected. Furniture and equipment were observed to be age appropriate and in good condition, free of sharp, loose, or pointed parts. Restrooms for children to use were observed to be in operating conditions. There is also enough chairs, tables, cubbies, mats, and toys in each classroom. Floors were clean. Disinfectants, cleaning solutions, poisons, sharps, and other items that are dangerous to children were stored inaccessible. Facility provides morning and afternoon snacks. Food storage area was inspected. Trash can for solid waste had tight fitting covers on.

The Preschool has three playgrounds that are fenced. LPA observed play equipment were maintained in a good condition, free of hazards. Areas around and under high climbing equipment were cushioned with material that absorbs falls. There were no bodies of water observed. Director stated that facility does not have weapons on the premises. Drinking water is arranged to be readily available to children. Shade is provided by trees, building overhang, canopy, etc. First Aid kit was inspected. LPA observed combination smoke and carbon monoxide detectors. Fire Extinguishers were last serviced on 8/4/2021. Log shows that the last fire/disaster drill was conducted on 9/15/2021. Facility has a Fire Prevention & Hazardous Material Consolidated Permit for "Fire Code Regulated Operation." The permit expires on 08/01/2023.
LPA reviewed facility's sign in/out procedure and record. A sampling of children files was selected for review. Records reviewed includes Admission Agreement, Identification and Emergency Information, Consent for Emergency Medical Treatment form, Medical Assessment, and immunization.

A sampling of Staff files was selected for review. Records reviewed include Criminal Record and Child Abuse Index Background Check Clearance, Health Screening Report with TB Clearance, Immunization Record for Measles and Pertussis, Education Qualification, and required Training. LPA reminded Director that the AB1207 Mandated Reporter Training needs to be renewed every two years. There was at least one person with documented current certification in Pediatric CPR/1st Aid present at the facility during LPA's inspection.
SUPERVISOR'S NAME: Sandy KnightTELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Stephanie CollinsTELEPHONE: (408) 334-8555
LICENSING EVALUATOR SIGNATURE:

DATE: 10/11/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2021
LIC809 (FAS) - (06/04)
Page: 2 of 4
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: PRESBYTERIAN EARLY LEARNING CENTER
FACILITY NUMBER: 430700524
VISIT DATE: 10/11/2021
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LPA reminded 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. For an initial violation, civil penalty amounts to $100.00 per person up to $500.00 per person. For a subsequent violation within a 12-month period, civil penalty amounts to $100.00 per person per day up to $3000.00 per person.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information, see Evaluator Manual – Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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.

LPA reviewed with Director the violations that would result in an immediate $500 civil penalty assessment. Director is encouraged to visit the Department’s website at www.cdss.ca.gov [Shortcut: ccld.ca.gov] to access resources for Providers, Regulations etc. Beginning January 1, 2019 AB2370 requires licensed homes and centers to share information on the risks and effects of lead exposure with enrolling and re-enrolling families.

Facility representative Darlene Ogasawara was reminded that all adults 18 and over, 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.

SUPERVISOR'S NAME: Sandy KnightTELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Stephanie CollinsTELEPHONE: (408) 334-8555
LICENSING EVALUATOR SIGNATURE:

DATE: 10/11/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2021
LIC809 (FAS) - (06/04)
Page: 3 of 4
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: PRESBYTERIAN EARLY LEARNING CENTER
FACILITY NUMBER: 430700524
VISIT DATE: 10/11/2021
NARRATIVE
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LPA discussed the safe sleep regulations with facility representative Darlene Ogasawara and discussed the Child Care Licensing Safe Sleep web page at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an a Darlene Ogasawar of additional resource. LPA also informed facility representative of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee [or facility representative] (include name).










SUPERVISOR'S NAME: Sandy KnightTELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Stephanie CollinsTELEPHONE: (408) 334-8555
LICENSING EVALUATOR SIGNATURE:

DATE: 10/11/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2021
LIC809 (FAS) - (06/04)
Page: 4 of 4