430703796-10-15-2019-07-CC-MSMS-BGYSB4-20191015134318

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 430703796
Report Date: 10/15/2019
Date Signed: 10/15/2019 01:43:23 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:	MISSION COLLEGE CHILD DEVELOPMENT CENTER		FACILITY NUMBER:	430703796
ADMINISTRATOR:	NAVARRO, KARIN		FACILITY TYPE:	850
ADDRESS:	3000 MISSION COLLEGE BLVD MS#6		TELEPHONE:	(408) 855-5177
CITY:	SANTA CLARA	STATE: CA	ZIP CODE:	95054
CAPACITY:	90	CENSUS: 36	DATE:	10/15/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	08:45 AM
MET WITH:	Karin Navarro & Tricia Darrell		TIME COMPLETED:	01:45 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) Mel Matos and Dung Mac met with Karin Navarro, director, for an unannounced annual/random inspection. The Facility is licensed on the campus of Mission College in the following rooms: Room 3 - Tulips (toddler option), Room 4 - Snapdragons, Artelier, Room 5 - Sunflowers, and Room 6 - Orchids. The Facility also has an infant program (#434406682) on site and that program is licensed in Room 1 (Bluebell) and Room 2 (Roses). LPAs toured the indoor and outdoor space of the Facility during today's inspection. LPAs 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, and Activity Schedule. Clearances for individuals at this facility who require caregiver background checks are issued by State Department and/or County Office of Education and do not come under the jurisdiction of Community Care Licensing. LPAs reviewed ten children's and ten teacher files during today's inspection. Each child's file reviewed contains the Information and Emergency Information form (LIC 700). All files reviewed contain the required transcripts/verification of experience. Each classroom has at least one staff with current CPR and First Aid certifications on file. Karin 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). LPAs observed that the teacher/child ratio was in compliance during today's inspection. Karin understands the conditions, limitations, and capacity specifications of the Facility license. The Facility is Title 5 funded and thus Title 5 ratios apply. Karin understands that children shall be visually supervised at all times. LPAs observed 2 teachers & 1 student with 4 toddler children in Room 3 - Tulips, 4 teachers & 1 student with 9 children in Room 4 - Snapdragons, 3 teachers & 2 students with 11 children in Room 5 (Sunflowers), and 1 teacher & 3 students with 12 children in Room 6 - Orchids during today's inspection. REPORT CONTINUED ON THE FOLLOWING PAGE (PAGE #2 - REPORT DATED 10/15/2019):

SUPERVISOR'S NAME: Diana Stephenson	TELEPHONE: (408) 324-2158
LICENSING EVALUATOR NAME: Melvin S Matos	TELEPHONE: (408) 334-8554
LICENSING EVALUATOR SIGNATURE:	DATE: 10/15/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2019

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: MISSION COLLEGE CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 430703796
	VISIT DATE: 10/15/2019

NARRATIVE

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CONTINUATION OF PREVIOUS PAGE (PAGE #1 - REPORT DATED 10/15/2019):

LPAs observed that all rooms are clean and safe for all children and staff. Karin states that Mission College provides the cleaning service Monday through Friday after hours. Drinking water is readily available for the children in each room and in the outdoor playground area via sippie cups, drinking fountains, and water jugs. LPAs observed solid waste containers with tight-fitting lids in each room. 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. Karin states that there are no weapons or firearms on the premises.

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. Cleaning supplies are inaccessible to the children. Any medications at the Facility are stored in each individual classroom.

LPAs observed all furniture and equipment is in good condition and safe for the children. The playground areas utilized by the children are surrounded by appropriate fencing and the outdoor surfaces are safe for the children. LPAs observed that the outdoor equipment is age appropriate and in good condition. There is sufficient resilient materials in the outdoor playground area. LPAs did not observe any bodies of water.

No deficiencies issued during today's inspection.

Licensing Forms, Title 22 Regulations and information can be obtained through the internet at www.cdss.ca.gov. LPAs conducted an exit interview with Tricia prior to the conclusion of today's inspection and advised her of the Lead Poisoning Facts Flyer that must be given to the parent(s)/guardian(s) of newly enrolled children.

A NOTICE OF SITE VISIT WAS ISSUED, POSTED NEAR THE ENTRANCE TO THE FACILITY, 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: 10/15/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2019

LIC809 (FAS) - (06/04)

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