434400057-8-26-2021-07-CC-MSMS-C69UWY-20210826155730

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434400057
Report Date: 08/26/2021
Date Signed: 08/26/2021 03:57:36 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:	PONDEROSA DISTRICT PRESCHOOL		FACILITY NUMBER:	434400057
ADMINISTRATOR:	MEHA RATNANI		FACILITY TYPE:	850
ADDRESS:	804 PONDEROSA AVENUE		TELEPHONE:	(408) 423-4017
CITY:	SUNNYVALE	STATE: CA	ZIP CODE:	94086
CAPACITY:	46	CENSUS: 10	DATE:	08/26/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	02:10 PM
MET WITH:	Meha Ratnani		TIME COMPLETED:	04:00 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 (LPA) Mel Matos met with Meha Ratnani, director, for an unannounced Required - 1 year inspection (KIT 2). LPA toured the Facility both indoor and outdoor areas of the Facility during today's inspection. LPA notes that the Facility is licensed in Portables 91 & 92 on the campus of Ponderosa Elementary School. 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. The program is operated by the Santa Clara Unified School District and all criminal background checks for staff are handled by the Department of Education and thus do not come under the jurisdiction of Community Care Licensing Division. LPA reviewed ten children's and three staff files (1 director & 2 teachers) 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/immunization records, and Health Screening Report. All staff have current certificates of completion of the Mandated Reporter Training for Child Care Workers on file. Meha and one teacher has current CPR and First Aid certifications on file. Meha 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). LPA observed that the teacher/child ratio was in compliance during today's inspection. Meha understands the conditions, limitations, and capacity specifications of the Facility license. Meha understands that children shall be visually supervised at all times.

SUPERVISOR'S NAME: Diana Stephenson	TELEPHONE: (408) 324-2158
LICENSING EVALUATOR NAME: Melvin S Matos	TELEPHONE: (408) 334-8554
LICENSING EVALUATOR SIGNATURE:	DATE: 08/26/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2021

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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: PONDEROSA DISTRICT PRESCHOOL	FACILITY NUMBER: 434400057
	VISIT DATE: 08/26/2021

NARRATIVE

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LPA observed one teacher with 10 napping preschool children in Portable 91 during today's inspection. Portable 92 is currently not in use due to low enrollment. The Facility is aware of the required sign in and sign out procedures for school age children who arrive on their own. Meha states that all school age children are picked up by their parent(s)/guardian(s) and no children are allowed to leave the Facility on their own.

LPA observed that the Facility is clean, safe, sanitary, and in good repair for children, staff, and visitors. Meha states that the Santa Clara Unified School District provides staff to clean the Facility Monday through Friday in the evenings. Meha understands that the Facility must be kept free of flies and other insects & rodents. LPA observed that all furniture and equipment is in good condition and safe for the children. Drinking water is readily available for the children in each Portable and in the outdoor playground area via water fountains/disposable cups/water bottles. 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. Meha states that there are no weapons or firearms on the premises. The Facility has functioning carbon monoxide detectors.

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. The Facility has trash cans with tight fitting lids for solid waste. Cleaning supplies are inaccessible to the children and stored in high cabinets and locked cabinets inaccessible to children. Any poisons are stored in the locked janitor closet, located near the kitchen area. Any medications at the Facility are stored in each individual Portable 91.

The playground area 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. Shade is provided by trees and canopies in the playground area. There is sufficient resilient materials (rubber surfacing) surrounding the age appropriate play structure in the outdoor playground area. LPA did not observe any bodies of water.

LPA conducted an exit interview with Meha 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: 08/26/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2021

LIC809 (FAS) - (06/04)

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