430710597-9-13-2019-07-CC-MSMS-BFYTG3-20190913144229

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 430710597
Report Date: 09/13/2019
Date Signed: 09/13/2019 02:42:35 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:	VARGAS SCHOOL AGE CHILD DEVELOPMENT CENTER		FACILITY NUMBER:	430710597
ADMINISTRATOR:	BEATRICE MARTINEZ		FACILITY TYPE:	840
ADDRESS:	1054 CARSON DRIVE		TELEPHONE:	(408) 736-0174
CITY:	SUNNYVALE	STATE: CA	ZIP CODE:	94086
CAPACITY:	105	CENSUS: 36	DATE:	09/13/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	12:15 PM
MET WITH:	Beatrice Martinez		TIME COMPLETED:	02:50 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	Licensing Program Analyst (LPA) Mel Matos met with Beatriz Martinez, director, for an unannounced annual/random inspection. The school age program is Licensed in Rooms 1, 2 ,& 22 on the campus of Vargas Elementary School and shares Rooms 1 & 2 with the preschool program (Facility #: 434410773) and Room 22 with the elementary school. The preschool program hours: 8:30 to 11:30 AM during the calendar school year. The school age program hours: 6:30 AM to 8 AM and 2 PM to 6 PM, except Friday: 12:30 PM to 6 PM. The school age program is open from 6:30 AM to 6 PM during school recess periods. Bonnie understands that the preschool and school age program cannot commingle. LPA observed the required posted materials, including the Facility License, Emergency Disaster Plan (LIC 610), Earthquake Preparedness Checklist (LIC 9148), Parents' Rights Poster (PUB 393), Personal Rights (LIC 613A), Child Car Seat Law (PUB 269), Menus, and Activity Schedule. LPA toured the Facility both inside and outside during today's inspection. LPA observed all furniture and equipment is in good condition and safe for the children. The playground areas utilized by children is surrounded by appropriate fencing and the outdoor surfaces are safe for the children. LPA observed that the outdoor equipment is age appropriate and in good condition. LPA did not observe any bodies of water. LPA notes that Rooms 1 & 2 have playground space located adjacent to those rooms. Room 22 uses the elementary school playground located closest to Room 22 which has an age appropriate climbing structure with rubber padding as resilient materials. LPA reviewed ten children's and six staff (1 director & 5 teachers) files during today's inspection Each child's file reviewed contains the Information and Emergency Information form (LIC 700). All staff files reviewed contain the required transcripts/verification of experience. Beatriz and all staff has current CPR and First Aid certifications on file. Beatriz understands that there shall be at least one person, with valid CPR and First Aid certifications, on site at all times or present during off-site activities (field trips). The Facility is aware of the required sign in and sign out procedures for school age children who arrive at the Facility on their own. Beatriz states that all children are picked up from the Facility by parents/authorized representatives. REPORT CONTINUED ON THE FOLLOWING PAGE (PAGE #2 - REPORT DATED 09/13/2019):

SUPERVISOR'S NAME: Diana Stephenson	TELEPHONE: (408) 324-2158
LICENSING EVALUATOR NAME: Melvin S Matos	TELEPHONE: (408) 334-8554
LICENSING EVALUATOR SIGNATURE:	DATE: 09/13/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2019

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: VARGAS SCHOOL AGE CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 430710597
	VISIT DATE: 09/13/2019

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CONTINUATION OF PREVIOUS PAGE (PAGE #1 - REPORT DATED 01/09/2017):

A review of staff records on September 11, 2019 indicates that all Facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. LPA reminded Beatriz 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. Penalty amounts: $100.00 per person per day, minimum of $100.00 to a maximum of $500.00 per person for an initial violation and a minimum of $100.00 to a maximum of $3000.00 per person for any subsequent violations within a 12 month period.

LPA observed that the teacher/child ratio was in compliance during today's inspection. LPA observed 8 school age children in Room 1 with three staff and 28 school age children with two staff in Room 2 during today's inspection. Beatriz understands the conditions, limitations, and capacity specifications of the Facility license. Beatriz understands that children shall be visually supervised at all times.

LPA observed that all rooms are clean and safe for all children and staff. Beatriz states that the Facility has a third-party cleaning service that cleans the Facility Monday through Friday in the evenings. Drinking water is readily available for the children in each room and in the outdoor playground area via pitchers/disposable cups. LPA observed solid waste containers with tight-fitting lids in each room. Staff and children's bathrooms are clean, sanitary, and operable. There is a separate staff bathroom not utilized by the children which an isolated child can use if needed. Beatriz states that there are no weapons or firearms on the premises. There is a functioning carbon monoxide detector in the Facility.

The food preparation and storage areas are clean, free of litter & rubbish, and free of rodents and other vermin. All food and beverages that require refrigeration are stored in covered containers at 45 degrees F or less. Cleaning supplies are inaccessible to the children and stored in high cabinets & locked cabinets inaccessible to children. Medications are stored in each classroom in an appropriate lock box.

LPA conducted an exit interview with Beatriz prior to the conclusion of today's inspection and advised her that no deficiencies issued during today's inspection.

A NOTICE OF SITE VISIT WAS ISSUED, POSTED NEAR THE ENTRANCE TO THE FACILITY, AND MUST REMAIN POSTED FOR 30 DAYS.

SUPERVISOR'S NAME: Diana Stephenson	TELEPHONE: (408) 324-2158
LICENSING EVALUATOR NAME: Melvin S Matos	TELEPHONE: (408) 334-8554
LICENSING EVALUATOR SIGNATURE:	DATE: 09/13/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2019

LIC809 (FAS) - (06/04)

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