430710539-8-28-2019-07-CC-TDON-BFGV4Q-20190828160643

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 430710539
Report Date: 08/28/2019
Date Signed: 08/28/2019 04:06:55 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:	CHALLENGER SCHOOL-SUNNYVALE		FACILITY NUMBER:	430710539
ADMINISTRATOR:	HENRY, JACQUELINE		FACILITY TYPE:	850
ADDRESS:	1185 HOLLENBECK AVENUE		TELEPHONE:	(408) 245-7170
CITY:	SUNNYVALE	STATE: CA	ZIP CODE:	94087
CAPACITY:	168	CENSUS: 53	DATE:	08/28/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Jacqueline Henry		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	Licensing Program Analysts (LPAs) Tuoc Doan and Dung Mac conducted an unannounced Annual inspection of the Preschool. LPAs met with Director Jacqueline Henry and informed her the purpose of the visit. Facility's License, Notification of Parents’ Right Poster, Children's Personal Rights, and Child Car Seat Law were observed to be posted. Operating days and hours are Monday-Friday 07:00 AM to 06:00 PM. Facility was observed to be in compliance with teacher to child ratio requirement during inspection. LPAs inspected the building inside and out. The Preschool operates in Rooms: E1, E2, E3, E4, E5, D1, and D2 [Previously known as Rooms: 2, 1, 27, 28, 29, 3, and 22, respectively]. Per Director, currently there are no children enrolled in Rooms D1, D2, and E1. The classrooms, restrooms, Office, and food Preparation areas were inspected. Furniture and equipment were observed to be age appropriate and in good condition, free of sharp, loose, or pointed parts. Restrooms for children to use were observed to be in operating conditions. Floors were clean. Disinfectants, cleaning solutions, poisons, sharps, and other items that are dangerous to children were stored inaccessible. Facility provides morning and afternoon snacks. Food storage area was inspected and trash can for solid waste had tight fitting covers on. Outdoor activity space is fenced. LPAs observed play equipment were maintained in a good condition, free of hazards. Areas around and under high climbing equipment were cushioned with material that absorbs falls. There were no bodies of water observed. Director stated that facility does not have weapons on the premises. Drinking water is arranged to be readily available. Shade is provided by trees, building overhang, etc. LPAs observed combination smoke and carbon monoxide detectors. Fire Extinguishers were last serviced on 12/2018. The first Fire/disaster drills for the new academic year is scheduled to take place on 08/30/19. Facility has a Fire Prevention & Hazardous Material Consolidated Permit for "Fire Code Regulated Operation. The permit expires on 12/01/2020.

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408)324-2151
LICENSING EVALUATOR NAME: Tuoc Doan	TELEPHONE: (408) 497-7322
LICENSING EVALUATOR SIGNATURE:	DATE: 08/28/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2019

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: CHALLENGER SCHOOL-SUNNYVALE	FACILITY NUMBER: 430710539
	VISIT DATE: 08/28/2019

NARRATIVE

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A sampling of of children files was selected for review. Records reviewed includes Admission Agreement, Identification and Emergency Information, Consent for Emergency Medical Treatment form, Medical Assessment, and immunization.

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/1st 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.

This facility provides Incidental Medical Services – IMS. Director stated that currently none of the children enrolled in Preschool requires the provision of IMS. 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.

Director is encouraged to visit the Department’s website at www.cdss.ca.gov [Shortcut: ccld.ca.gov] to access resources for Providers, Regulations etc. 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. LPA provided a copy of the “Lead Poisoning Facts Information Flyer” to the facility.

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: 08/28/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2019

LIC809 (FAS) - (06/04)

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