430709698-8-16-2019-07-CC-TDON-BF4W3N-20190816165614

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 430709698
Report Date: 08/16/2019
Date Signed: 08/16/2019 04:56:27 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:	PRESBYTERIAN EARLY LEARNING CENTER		FACILITY NUMBER:	430709698
ADMINISTRATOR:	RANDLE, GRACE		FACILITY TYPE:	830
ADDRESS:	728 W. FREMONT AVENUE		TELEPHONE:	(408) 245-2253
CITY:	SUNNYVALE	STATE: CA	ZIP CODE:	94087
CAPACITY:	8	CENSUS: 0	DATE:	08/16/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	02:40 PM
MET WITH:	Grace Randle & Darlene Ogasawara		TIME COMPLETED:	05:00 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	Licensing Program Analyst (LPAs) Tuoc Doan and Stephanie Collins conducted an unannounced Annual inspection of the Infant Program. LPAs met with Director Grace Randle and Assistant Director Darlene Ogasawara and explained the purpose of the inspection. Facility operating days and hours are Monday through Friday 9:00 AM to 2:00 PM. Facility’s License, Parents’ Rights Poster, and Personal Rights were observed to be posted. Upon arrival, Director informed LPAs that the facility has been on break from 07/27/19 to 08/16/19. School session will start on 08/19/19. LPAs inspected the physical plant.The Infant Program is located in Room 902 of building 900. There were no bodies of water observed. Director stated that facility does not possess nor store any weapons on the premises. Disinfectants, cleaning solutions, poisons, sharps, and other items that are dangerous to infants were stored inaccessible. Facility provides snacks. Storage containers for solid waste had tight fitting covers and were in good repair. Furniture and equipment such as cribs and changing table were in sanitary and safe condition, free of sharp, loose, or pointed parts. There were no baby walkers observed on the premises during the inspection. Infant outdoor activity space is enclosed with fencing. Play equipment were maintained in a safe condition and free of hazards. Areas around and under high climbing equipment were cushioned with material that absorbs falls. Drinking water is arranged to be readily available for infants in care. Foods and beverages were kept protected against contamination and spoilage. Director understands that bottles and containers of food brought into the facility by the infant's authorized representative needs to be individually labeled with the infant's name and current date. First Aid Kit was inspected. LPAs observed smoke and carbon monoxide detectors. Fire Extinguisher was last serviced on 06/2019. Log shows that the last fire/disaster drill was conducted on 08/12/19

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408)324-2151
LICENSING EVALUATOR NAME: Tuoc Doan	TELEPHONE: (408) 497-7322
LICENSING EVALUATOR SIGNATURE:	DATE: 08/16/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2019

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: PRESBYTERIAN EARLY LEARNING CENTER	FACILITY NUMBER: 430709698
	VISIT DATE: 08/16/2019

NARRATIVE

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A sampling of Infant files for the infants enrolled in the upcoming school session was selected for review. Records reviewed includes Admission Agreement, Identification and Emergency Information, Consent for Emergency Medical Treatment form, and Needs and Services Plan. Safe sleep information for infants was reviewed with Director.

A sampling of Staff files was selected for review. Records reviewed include Criminal Record and Child Abuse Index Background Check Clearance, Health Screening Report with TB Clearance, Immunization Record for Measles and Pertussis, Education Qualification, and required Training. LPA reminded Director that the AB1207 Mandated Reporter Training needs to be renewed every two years. There was at least one person with documented current certification in Pediatric CPR and First Aid present at the facility during LPA's inspection.

LPA reminded Director of the applicable civil penalties for those adults who have not received fingerprint clearances, are not associated to the license, and who come in contact with or provide care and supervision to the children. For an initial violation, civil penalty amounts to $100.00 per person up to $500.00 per person. For a subsequent violation within a 12-month period, civil penalty amounts to $100.00 per person per day up to $3000.00 per person.

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 Asked Questions about Child Care centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

In the areas that were evaluated, no regulatory violations were observed at the time of the inspection. Exit interview was conducted, where this report was reviewed with Director.

A NOTICE OF SITE VISIT WAS ISSUED AND MUST BE POSTED ON OR ADJACENT TO THE INTERIOR SIDE OF THE MAIN DOOR INTO THE FACILITY FOR 30 CONSECUTIVE DAYS.

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408)324-2151
LICENSING EVALUATOR NAME: Tuoc Doan	TELEPHONE: (408) 497-7322
LICENSING EVALUATOR SIGNATURE:	DATE: 08/16/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2019

LIC809 (FAS) - (06/04)

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