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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 430706092
Report Date: 10/15/2019
Date Signed: 10/15/2019 10:55:15 AM

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:CHANDLER TRIPP HEAD STARTFACILITY NUMBER:
430706092
ADMINISTRATOR:PATTERSON, SHEILAFACILITY TYPE:
850
ADDRESS:780 THORNTON WAYTELEPHONE:
(408) 293-8404
CITY:SAN JOSESTATE: CAZIP CODE:
95128
CAPACITY:40CENSUS: 22DATE:
10/15/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
08:54 AM
MET WITH:Dung VoTIME COMPLETED:
11:00 AM
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Licensing Program Analyst (LPA), Marilou Monico, met with Site Director, Dung Vo, for an unannounced annual random inspection. The preschool program is licensed in Rooms 1 and 2. LPA observed all required posted materials: License, Parents' Rights, Emergency Disaster Plan, menus, Earthquake Preparedness Checklist, Child Passenger Safety Law, menus, and activity schedule. The preschool program's days and hours of operation are Monday to Friday from 8:00 AM to 5:00 PM.

LPA inspected the building both indoor and outdoor. LPA observed that the facility was operating in compliance with teacher to children ratio requirement. Children were engaged in activities under the supervision of the teachers. Children and staff bathrooms are sanitary and operable. LPA observed trash cans with tight fitting covers in the classrooms for the disposal of solid waste. Drinking water indoor is via water dispenser and disposable cups. Cleaning products, sharps objects, and other similar items were stored inaccessible to children. There is functioning carbon monoxide detector and smoke detectors at the facility. LPA did not observe any bodies of water. LPA reviewed six random children's files and four staff files. At least one staff member present during the inspection has current CPR/First Aid certifications. Per Site Director, there are no weapons on the premises. LPA obtained copies of children's roster.

Outdoor activity areas are enclosed by fencing. Shade is provided by trees and canopy. The areas around climbing equipment and swings have rubber foam as resilient material to absorb falls. Drinking water was readily available to children outdoor via water jug and disposable cups. Facility provides breakfast, lunch, and afternoon snacks. There is a kitchen between Rooms 1 and 2 for food preparation. The kitchen is equipped with refrigerators, microwave, stove, oven, and sink with hot and cold running water. Sanitation is by hand washing. LPA observed that food storage areas were clean, free of litter, and rodents.

(REPORT CONTINUED ON THE FOLLOWING PAGE (PAGE #2 - REPORT DATED 10/15/19):
SUPERVISOR'S NAME: Anthony StudebakerTELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Marilou MonicoTELEPHONE: (408) 334-8549
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)
Page: 1 of 2
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: CHANDLER TRIPP HEAD START
FACILITY NUMBER: 430706092
VISIT DATE: 10/15/2019
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CONTINUATION OF PREVIOUS PAGE (PAGE #1 - REPORT DATED 10/15/19):

Fingerprint clearances for individuals working at the facility are issued by the Santa Clara Department of Education and do not come under the jurisdiction of Community Care Licensing Division.

LPA discussed Senate Bill 792, AB 633, Assembly Bill (AB) 1207 (Mandated Child Abuse Reporter Training) which is required training that began on January 1, 2018 and requires renewal every two years with Site Director. Licensing forms, Title 22 regulations, can be obtained through the internet at ww.ccld.ca.gov. Mandated Reporter Training can be accessed at www.mandatedreporterca.com.

Beginning January 1, 2019 AB2370 requires licensed homes and centers to share information on the risks and effects of lead exposure with enrolling and re-enrolling families. LPAs provided a copy of the “Lead Poisoning Facts Information Flyer” to the facility.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.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.

As a result of this inspection, there were no deficiencies cited.



A NOTICE OF SITE VISIT WAS ISSUED AND MUST BE POSTED FOR 30 CONSECUTIVE DAYS.
SUPERVISOR'S NAME: Anthony StudebakerTELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Marilou MonicoTELEPHONE: (408) 334-8549
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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