430702027-11-10-2021-07-CC-MSMS-C8MVX2-20211110154849

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 430702027
Report Date: 11/10/2021
Date Signed: 11/10/2021 03:48:57 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:	SUNNYVALE CHRISTIAN SCHOOL		FACILITY NUMBER:	430702027
ADMINISTRATOR:	DICKSON, MARGO		FACILITY TYPE:	850
ADDRESS:	445 SOUTH MARY AVENUE		TELEPHONE:	(408) 736-3286
CITY:	SUNNYVALE	STATE: CA	ZIP CODE:	94086
CAPACITY:	98	CENSUS: 46	DATE:	11/10/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:35 PM
MET WITH:	Margo Dickson		TIME COMPLETED:	04:00 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) Mel Matos met with Margo Dickson, Director, for an unannounced Required - 1 Year inspection. LPA toured the indoor and outdoor areas of the Facility with Margo 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), Menus, current Fire Drill Log, and Activity Schedule. Days and hours of operation are Monday through Friday 7:30 AM to 5:30 PM. The Facility is licensed to serve a maximum of 98 preschool children ages two to 6 years in Rooms 1-3, 5-8, Senior Lounge, and Fireside Room Parlour (for rainy day activities). The Facility has two active waivers on file (shared playground and shared bathroom use with private K-5 school operated by the same entity) and is in compliance with the conditions of both waivers. Margo 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. LPA reviewed ten children's and eight staff files (1 director, 6 teachers, & 1 aide) during today's inspection. Each child's file reviewed contains the Information and Emergency Information form (LIC 700), vaccination records, and all other required licensing forms. The Facility is in compliance with the sign in and sign out requirements. All staff files reviewed contain the required transcripts/verification of experience/immunization records, Health Screening Report, and all other required licensing forms. All staff have current certificates of completion of the Mandated Reporter Training for Child Care Workers and current CPR & First Aid certifications on file. Margo 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).

SUPERVISOR'S NAME: Diana Stephenson	TELEPHONE: (408) 324-2158
LICENSING EVALUATOR NAME: Melvin S Matos	TELEPHONE: (408) 334-8554
LICENSING EVALUATOR SIGNATURE:	DATE: 11/10/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/10/2021

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: SUNNYVALE CHRISTIAN SCHOOL	FACILITY NUMBER: 430702027
	VISIT DATE: 11/10/2021

NARRATIVE

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LPA observed that the teacher/child ratio was in compliance during today's inspection. LPA observed 12 napping children with 1 teacher in Room 8, 10 napping children with 1 teacher in Room 7, five napping children with 1 teacher & 1 aide in Room 6, eight napping children with 1 teacher in Room 5, five napping children with 1 teacher in Room 2, & six napping children with 1 teacher in Room 1 during today's inspection. Margo understands the conditions, limitations, and capacity specifications of the Facility license. Margo 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 in the main office area.

LPA observed that the Facility is clean, safe, sanitary, and in good repair for children, staff, and visitors. The Facility maintains a comfortable temperature by way of heating/air conditioning units and proper ventilation. Margo states that the Facility has a third party service that cleans the Facility Monday through Friday in the evenings. Margo understands 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 and in the outdoor playground area via water coolers/water bottles. Staff and children's bathrooms are clean, sanitary, and operable. There is a separate staff bathroom not utilized by the children which an isolated child can use if needed. Margo states that there are no weapons or firearms on the premises. The Facility has functioning carbon monoxide detectors in each classroom.

The food preparation and storage areas are clean, free of litter & rubbish, and free of rodents and other vermin. All food and beverages that require refrigeration are stored in covered containers at 45 degrees F or less. The Facility provides snacks for the children. Margo states that children bring their own lunches from home. The Facility has trash cans with tight fitting lids for solid waste in each classroom. Cleaning supplies are inaccessible to the children and stored in locked and high cabinets inaccessible to children. There are no poisons in the Facility. LPA observed a complete First Aid kit, including touch less thermometer, in the Facility.

SUPERVISOR'S NAME: Diana Stephenson	TELEPHONE: (408) 324-2158
LICENSING EVALUATOR NAME: Melvin S Matos	TELEPHONE: (408) 334-8554
LICENSING EVALUATOR SIGNATURE:	DATE: 11/10/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/10/2021

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: SUNNYVALE CHRISTIAN SCHOOL	FACILITY NUMBER: 430702027
	VISIT DATE: 11/10/2021

NARRATIVE

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The playground area utilized by children is surrounded by appropriate fencing and the outdoor surfaces are safe for the children. There is adequate equipment and supplies for children outdoors. LPA observed that the outdoor equipment is age appropriate and in good condition. Shade is provided by trees and building overhangs. There is sufficient resilient materials in the outdoor playground area (wood chips & rubber surfacing). LPA did not observe any bodies of water. Margo states that the Facility does not provide transportation.

This Facility is not providing Incidental Medical Services – IMS at this time. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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. Margo states that the Facility does not administer any medication at this time.

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/inspection-process

Exit interview conducted and report was reviewed with the Director, Margo Dickson.

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

SUPERVISOR'S NAME: Diana Stephenson	TELEPHONE: (408) 324-2158
LICENSING EVALUATOR NAME: Melvin S Matos	TELEPHONE: (408) 334-8554
LICENSING EVALUATOR SIGNATURE:	DATE: 11/10/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/10/2021

LIC809 (FAS) - (06/04)

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