430702374-12-2-2021-07-CC-SYIP-C9C43P-20211202174501

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 430702374
Report Date: 12/02/2021
Date Signed: 12/02/2021 05:45:12 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:	VINEYARD PRESCHOOL		FACILITY NUMBER:	430702374
ADMINISTRATOR:	JENNY MOSHER		FACILITY TYPE:	850
ADDRESS:	1735 HECKER PASS		TELEPHONE:	(408) 847-8463
CITY:	GILROY	STATE: CA	ZIP CODE:	95020
CAPACITY:	45	CENSUS: 39	DATE:	12/02/2021
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	10:09 AM
MET WITH:	Jenny Mosher		TIME COMPLETED:	12:25 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 Analysts (LPAs) Samantha Yip and Marilou Monico conducted an unannounced Case Management- Licensee Initiated. LPAs met with Director Jenny Mosher and explained the reason for the inspection. Facility requested for a change of capacity from 45 to 50 children and are adding a room (Pre-K 2). A fire clearance for 50 children was granted on 11/08/2021. Present during today's inspection were 39 children and at least 4 staff. All staff present have cleared criminal record clearance. The indoor and outdoor areas were measured during today's inspection. The measurements are as followed: Upstairs Room: 20.500 x 17.917 = 367.298 + 17 x 19.583 = 332.911 + 27.333 x 18.083 = 494.262 = 1194.471 minus encumbered space 4 x 2.167= 8.668 + 2(11.167 x 2.167)= 48.397 = 57.065 = 1194.471- 48.397 = 1137.406 Pre-K 1: 29.417x 15.750 = 463.317 + 9.667 x 1.417= 13.698 + 6 x 0.083 = 0.498 = 449.121 Pre-K 2: 16.333 x 29.417 = 480.467 Total indoor square footage: 1137.406 + 449.121 + 480.467 = 2066.994 divided by 35 = 59 children --------------------CONTINUES ON 809 DATED 12/02/2021 PAGE 2-------------------------------

SUPERVISOR'S NAME: Joel Segura	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Samantha Yip	TELEPHONE: (408) 529-8128
LICENSING EVALUATOR SIGNATURE:	DATE: 12/02/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2021

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: VINEYARD PRESCHOOL	FACILITY NUMBER: 430702374
	VISIT DATE: 12/02/2021

NARRATIVE

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----------------------CONTINUATION OF 809 DATED 12/02/2021 PAGE 1----------------------

Outdoor Space Measurement:
21.417 x 6.083 = 130.279 + 41.917 x 50 = 2095.85 + 59.583 x 69.083 = 4116.172 +
1/2 (53x 69.083)= 1830.699 = 8173

Total Outdoor Square Footage: 8173 divided by 75 =108

There are 10 tables, 61 chairs, 4 toilets, and 5 sinks. Children in the Upstairs Room and the Pre-K 2 Room will be using individual baskets for their belongings. There are 18 baskets in the Upstairs Room. The Pre-K 1 Room has 11 cubbies and 10 hooks. There is sufficient amount of toys for children. Facility only provides snacks to children, which is either provided by parents and the faciltiy. There is an area to store snacks. All meals are prepared and brought from home. Drinking water is provided through individual water bottles, water pitchers, and water fountains. Storage containers for waste have tight fitted lids. Shaded rest area is provided through building overhang and trees. Facility has a waiver to use the staff bathroom for sick children.

Facility will submit facility sketch to Licensing.

Based on the approved fire clearance capacity and the indoor and outdoor square footage measurements, the facility physical plant has been approved and an updated license reflecting the request to increase capacity will be issued pending Community Care Licensing Management Approval.

No deficiencies were cited as a result of today's inspection. Exit interview conducted and report was reviewed with Director Jenny Mosher. A Notice of Site Visit was given and must remain posted for 30 days.

SUPERVISOR'S NAME: Joel Segura	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Samantha Yip	TELEPHONE: (408) 529-8128
LICENSING EVALUATOR SIGNATURE:	DATE: 12/02/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2021

LIC809 (FAS) - (06/04)

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