430703796-9-12-2023-07-CC-AMOS-CVLTGY-20230912144351

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 430703796
Report Date: 09/12/2023
Date Signed: 09/12/2023 02:43:58 PM

Document Has Been Signed on 09/12/2023 02:43 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE CC RO, 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: 24	DATE:	09/12/2023
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	10:20 AM
MET WITH:	Anne Horgan		TIME COMPLETED:	01:50 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 09/12/2023, Licensing Program Analysts (LPAs), Anna Morales and Marilou Monico met with Program Director, Anne Horgan, to conduct an unannounced case management inspection. The purpose of the visit is to remeasure the preschool and the toddler option classrooms. Applicant requested Toddler Option for 12 children for the TULIP classroom. Facility is licensed to serve 74 children ages 3-5 years in old in Rooms, Sunflowers, Orchids and Snapdragons and 16 children ages 18-36 months in the Toddler Option Classroom, Tulips. LPA's toured the facility as well as measured the space available for the children. The following measurements were taken during today's inspection: Indoor Activity Space: TODDLER OPTION TULIP ROOM: 41.833 x 23.583 =986.547 minus 154.741 (encumbered space) = 831.806 *Total Toddler Option Indoor Space = 831.806 sq.ft. divided by 35 = 23 children* Outdoor Activity Space: TODDLER OPTION 68.583 x 37.750 = 2,589.008 16.000 x 18.667= 298.672 2,887.68 minus 14.780 (encumbered space) = 2,872.9 Total Toddler Option Outdoor Space = 2,872.9 divided by 75 sq feet = 38 children The Toddler Option Program has 5(75) sinks, 2(30) toilets, 18 cubbies, 20 chairs, 4 tables and 16 cots. LPAs observed a diaper changing table within arm's reach of a sink in the Toddler Room. *Continuation on next page:*

SUPERVISOR'S NAME: Gladys Kuizon	TELEPHONE: (510) 566-5850
LICENSING EVALUATOR NAME: Anna Morales	TELEPHONE: (408) 334-8325
LICENSING EVALUATOR SIGNATURE:	DATE: 09/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/12/2023

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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: MISSION COLLEGE CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 430703796
	VISIT DATE: 09/12/2023

NARRATIVE

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Indoor Measurements for PRESCHOOL CLASSROOMS:
SNAPDRAGON: 41.833x 23.583= 986.547 minus 154.741(encumbered)=831.806
ORCHID: 37.250 x 27.500=1,024.375 minus 188.774 (encumbered)=835.601
SUNFLOWER: 37.583 x 27.583 =1,036.651
10.417 x 12.500= 130.212
1,166.863 minus 201.726 (encumbered)=965.137
TOTAL PRESCHOOL INDOOR SPACE = 2,632.544 divided by 35 sq. ft. = 75 children

Outdoor Measurements for PRESCHOOL PLAYGROUNDS:
SNAPDRAGON PLAYGROUND: 107.167 x 23.583= 2,527.319 minus 41.167(encumbered) =2,486.152

Measurements for Sunflowers & Orchids Playground were taken by LPA Ikkanda on 12/12/11:
SUNFLOWER AND ORCHID:
30 X 48.166 + 34.664 X 1/2(42.415) + 12.415 X 34.664 + 68.747 X 26 + 34.332 X 1/2(35.664 + 34.332 X1/2( 54) = 5937.063

TOTAL PRESCHOOL OUTDOOR SPACE = 8,235.215 divided by 75 sq.ft. = 112 children

LPA's observed a total of 11(165) sinks, 6(90) toilets, 66 cubbies, 69 chairs, 12 tables and 51 cots.

Licensure of 75 children in the preschool program and 12 children in the toddler option playground will be granted pending the following:
1) Approved fire clearance
2) Management review and approval

No deficiencies cited during today's visit.
Exit interview was conducted and report was reviewed with Program Director, Anne Horgan.

SUPERVISOR'S NAME: Gladys Kuizon	TELEPHONE: (510) 566-5850
LICENSING EVALUATOR NAME: Anna Morales	TELEPHONE: (408) 334-8325
LICENSING EVALUATOR SIGNATURE:	DATE: 09/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/12/2023

LIC809 (FAS) - (06/04)

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