430709420-7-14-2021-52-CC-MESA-C4WUY2-20210714155913

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 430709420
Report Date: 07/14/2021
Date Signed: 07/14/2021 03:59:23 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME:	MILPITAS CHRISTIAN PRESCHOOL		FACILITY NUMBER:	430709420
ADMINISTRATOR:	SHEILA TANIMURA		FACILITY TYPE:	850
ADDRESS:	1000 S. PARK VICTORIA DRIVE		TELEPHONE:	(408) 945-6530
CITY:	MILPITAS	STATE: CA	ZIP CODE:	95035
CAPACITY:	180	CENSUS: 47	DATE:	07/14/2021
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Sheila Tanimura		TIME COMPLETED:	04:15 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 Wednesday, July 14, 2021 3:00 PM, Licensing Program Analyst (LPA) Manel Estoesta conducted an unannounced Case Management visit. LPA met with the Director Sheila Tanimura and explained the nature of site visit. Present on this visit were 17 staff and 47 preschool children. Facility operates from Monday to Friday 7:30 am to 6pm. Unusual Incident Reported by the Director on 07/02/2021 via a phone call to the Regional Office. Incident happened on 07/01/2021 regarding a child remained in the gated play area for three (3 minutes) during a transition time from the playground. LIC 624 submitted via fax on 07/07/2021. Similar incident reported and happened on 05/27/2021. A child was left unattended in the play area during a outdoor play transition. A Type A violation was cited on 06/14/2021 Case Management visit for this incident and a immediate civil penalty was assessed. Absence of supervision is being cited today and this is a repeat violation. Lack of supervision poses an immediate risk to children in care and it is a Type A deficiency, which must be corrected by the Plan of Correction (POC) due date of 07/21/2021. The director acknowledges that upon receipt of a Type A deficiency, the Licensee shall post the LIC 809-D with the Type A deficiency for 30 days. Further, because a Type A deficiency was cited during this visit, the Licensee must provide a copy of this report to all parents, as well as newly enrolled parents, for the next 12 months. Additionally, form LIC 9224 (Acknowledgment of Receipt of Licensing Reports) must be signed by each existing parent and newly enrolled parent and a copy of that signed LIC 9224 form be placed in each child's file during the next 12 months. See 809 C for continuation.....

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Manel Estoesta	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 07/14/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/14/2021

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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: MILPITAS CHRISTIAN PRESCHOOL	FACILITY NUMBER: 430709420
	VISIT DATE: 07/14/2021

NARRATIVE

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Continuation.....

LPA discussed to Director about if the facility is interested in a Stakeholder In Service Training that the Child Care Program offers. The Director stated that she is interested and will let know the LPA.

An exit interview was conducted where the citation and plan of correction were discussed. Appeal rights were given and explained to the Licensee. Notice of Site Visit was posted.

The appeals rights were provided. A copy of this report was also provided and is to be kept in the facility records for a period of three years.

A NOTICE OF SITE VISIT WAS PROVIDED. IT MUST BE POSTED NEAR THE FACILITY'S FRONT ENTRANCE AND MUST REMAIN POSTED FOR 30 DAYS

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Manel Estoesta	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 07/14/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/14/2021

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: MILPITAS CHRISTIAN PRESCHOOL	FACILITY NUMBER: 430709420
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/14/2021

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 07/14/2021 Section Cited	1 2 3 4 5 6 7	Repeat violation of the following; CCR 101229 (a)(1)No child(ren) shall be left without the supervision, including visual supervision, of a teacher at any time......
	8 9 10 11 12 13 14	Based on record review, staff did not ensure the preschoold child was accounted for prior to a outdoor play transition for 3 minutes This poses an immediate risk to the health and safety of children in care. An Immediate Civil penalty is being assessed for a repeat violation.	8 9 10 11 12 13 14	https://ccld.childcarevideos.org/child-care-center-operators/child-care-reporting-requirements/ https://ccld.childcarevideos.org/child-care-center-operators/what-is-a-civil-penalty/ https://ccld.childcarevideos.org/child-care-center-operators/supervising-children-in-child-care-centers/
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Manel Estoesta	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 07/14/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/14/2021

LIC809 (FAS) - (06/04)

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