430703793-3-2-2022-52-CC-MESA-CC5PEE-20220302101502

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 430703793
Report Date: 02/25/2022
Date Signed: 03/02/2022 10:15:09 AM

Document Has Been Signed on 03/02/2022 10:15 AM - 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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME:	ROSE CHILD DEVELOPMENT CENTER		FACILITY NUMBER:	430703793
ADMINISTRATOR:	KATHLEEN LINCOLN		FACILITY TYPE:	850
ADDRESS:	250 A ROSWELL DRIVE		TELEPHONE:	(408) 635-2686
CITY:	MILPITAS	STATE: CA	ZIP CODE:	95035
CAPACITY:	100	CENSUS: 17	DATE:	02/25/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:45 AM
MET WITH:	Gerardo Lopez		TIME COMPLETED:	12:00 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	On Friday, February 25, 2022 at 8:45 AM, Licensing Program Analyst (LPA) Manel Estoesta and Licensing Program Manager (LPM) Jason Jang conducted an unannounced Required One (1) Year. LPA met with the Facility Representative / Coordinator Gerardo Lopez and explained the nature of the Site Visit. The facility has an active School Age License in the same Facility Address. Present on this visit were 17 preschool children and 7 Staff. Facility operates from Monday to Friday from 7:30am to 5:30pm. This facility is operated by the Milpitas Unified School District and all Criminal background checks for staff are handled by the Department of Education. LPA and LPM toured the facility to conduct a health and safety inspection with the Facility Representative. The facility consists of three (3) rooms as Room B, D and E. Personnel files were reviewed today. The teacher/child ratio is being met. A percentage of children's files were reviewed at 10 AM. The classroom and play yard were age appropriate and in good repair. Bathrooms were clean and in working order. There is a separate staff bathroom. The kitchen area was maintained in a clean manner. Lunches and snacks are provided by facility. All posting requirements are being met. Waste containers have tight fitting lids. The storage of napping equipment was observed. The sign in and out logs were reviewed. Firearms and other weapons are not being stored on the premises. Outdoor play area was free of hazards and provided a shaded area for the children and access to drinking water. Playground equipment is cushioned with material that absorbs a fall. The facility has a waiver of Playground being shared with the School Age Program. There are no bodies of water. The facility has a carbon monoxide detector, charged fire extinguishers and first aid kits. Fire and disaster drills are being conducted. There is a working telephone at the facility. More than one person trained in CPR and Pediatric First Aid is present. SEE 809 C.

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Manel Estoesta	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 02/25/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/25/2022

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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: ROSE CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 430703793
	VISIT DATE: 02/25/2022

NARRATIVE

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LPA discussed to the Facility Representative:
1. PIN 21-21-CCP RELEASE OF THE WRITTEN DIRECTIVES FOR LEAD TESTING OF WATER IN LICENSED CHILD CARE CENTERS PER AB 2370 https://cdss.ca.gov/inforesources/child-care-licensing/water-testing-information
2. AB 1207 - CALIFORNIA CHILD CARE PROVIDERS: MANDATED REPORTER TRAINING (2 year renewal requirement)
https://mandatedreporterca.com/training/child-care-providers
3. For questions about registration or your stipend, please call 1-833-398-1399. Hours of operation are 6:00am – 6:00pm CST, email - ARPASurvey@cde.ca.gov
https://www.cdss.ca.gov/inforesources/cdss-programs/community-care-licensing/child-care-licensing/licensed-stipends CCLliscensedstipends@dss.ca.gov
4. Santa Clara County Office of Education Childcare Resource & Referral Program contact information;
1290 Ridder Park Drive San Jose, CA 95131-2304, Email: childcarescc@sccoe.org, Phone: 669-212-KIDS (5437), Hours: Monday – Friday 8:30 a.m.– 4:30 p.m. and website https://www.childcarescc.org/child-care-application

Incidental Medical Services (IMS) policy was discussed. 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 AskedQuestions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

Facility Representative 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.

SEE 809 C.

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Manel Estoesta	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 02/25/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/25/2022

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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: ROSE CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 430703793
	VISIT DATE: 02/25/2022

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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.

As a result of this inspection, there are no deficiencies cited during today's inspection.

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

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the licensee, Facility Representative / Coordinator Gerardo Lopez.

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Manel Estoesta	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 02/25/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/25/2022

LIC809 (FAS) - (06/04)

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