430701365-1-15-2020-07-CC-MMOO-BKUW4Y-20200115155819

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 430701365
Report Date: 01/15/2020
Date Signed: 01/15/2020 03:58:24 PM

COMPREHENSIVE INSPECTION

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:	VILLAGE LITTLE		FACILITY NUMBER:	430701365
ADMINISTRATOR:	DAVID DESAGUN		FACILITY TYPE:	850
ADDRESS:	10100 N STELLING ROAD		TELEPHONE:	(408) 438-3029
CITY:	CUPERTINO	STATE: CA	ZIP CODE:	95014
CAPACITY:	120	CENSUS: 84	DATE:	01/15/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	11:34 AM
MET WITH:	Amy Spillar & Marti Eccles		TIME COMPLETED:	04:10 PM

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), Marilou Monico, met with Site Director, Amy Spillar, and Program Director, Marti Eccles, for an unannounced annual random inspection. The facility is licensed in Rooms 17 thru 24 and Kirkish Hall. LPA observed all required posted materials: License, Parent’s Rights, Emergency Disaster Plan, menus, Earthquake Preparedness Checklist, Child Passenger Safety Law, and activity schedule. The preschool program's days and hours of operation are Monday to Friday from 7:00 AM to 6:00 PM. LPA inspected the building both indoor and outdoor. LPA observed that the facility was operating in compliance with teacher to children ratio requirement. Children were engaged in activities under the supervision of the teachers. Children and staff bathrooms are sanitary and operable. LPA observed trash cans with tight fitting covers at the facility for the disposal of solid waste. Functioning carbon monoxide detector and smoke detector were observed at the facility. Drinking water indoor is via pitchers and disposable cups and drinking fountains. LPA did not observe any bodies of water. LPA reviewed 10 random children's files and six staff files. Four Evaluation of Teacher Qualifications were completed. At least one staff member present during the inspection has current CPR/First Aid certifications. Per Program Director, there were no weapons on the premises. Parents or authorized representatives utilized an electronic system to sign in/out their children. The facility has current children's roster. LPA obtained copy of children's roster. Outdoor activity space is enclosed by fencing. Shade is provided by trees and canopies. The areas around high climbing equipment have tanbarks as resilient material. Drinking water was readily available to children outdoor via drinking fountains. Facility provides snacks and lunch to the children. There is a kitchen at the facility for food preparation. The kitchen is equipped with refrigerator, microwave, stove, oven, and sink with hot and cold running water. Sanitation is by the dishwasher. LPA observed that food storage areas were clean, free of litter, and rodents. REPORT CONTINUED ON THE FOLLOWING PAGE (PAGE #2 - REPORT DATED 01/15/2020):

SUPERVISOR'S NAME: Anthony Studebaker	TELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Marilou Monico	TELEPHONE: (408) 334-8549
LICENSING EVALUATOR SIGNATURE:	DATE: 01/15/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2020

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: VILLAGE LITTLE	FACILITY NUMBER: 430701365
	VISIT DATE: 01/15/2020

NARRATIVE

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CONTINUATION OF PREVIOUS PAGE (PAGE #1 - REPORT DATED 01/15/2020):

Staff present during the inspection have cleared criminal record and child abuse index clearances or exemptions. LPA also reminded Site 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. Penalty amounts: minimum of $100.00 to a maximum of $500.00 per person for an initial violation and a minimum of $100.00 to a maximum of $3000.00 per person for any subsequent violation within a 12 month period.

LPA discussed Senate Bill 792, AB 633, Assembly Bill (AB) 1207 (Mandated Child Abuse Reporter Training) which is required training that began on January 1, 2018 and requires renewal every two years with Site Director. Licensing forms, Title 22 regulations, can be obtained through the internet at ww.ccld.ca.gov. Mandated Reporter Training can be accessed at www.mandatedreporterca.com.

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. LPA provided a copy of the “Lead Poisoning Facts Information Flyer” to the facility.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records.

Designation of Facility Responsibility (LIC 308) with original signature of Licensee Representative, David Desagun, to be sent to Licensing by 01/31/2020.

As a result of this inspection, there were no deficiencies cited.

A NOTICE OF SITE VISIT WAS ISSUED AND MUST BE POSTED FOR 30 CONSECUTIVE DAYS.

SUPERVISOR'S NAME: Anthony Studebaker	TELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Marilou Monico	TELEPHONE: (408) 334-8549
LICENSING EVALUATOR SIGNATURE:	DATE: 01/15/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2020

LIC809 (FAS) - (06/04)

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