434404878-8-14-2019-07-CC-ZHAM-BF339H-20190814180309

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434404878
Report Date: 08/14/2019
Date Signed: 08/14/2019 06:03:14 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:	MARIPOSA MONTESSORI SCHOOL		FACILITY NUMBER:	434404878
ADMINISTRATOR:	REKHA CLAYTOR		FACILITY TYPE:	850
ADDRESS:	16548 FERRIS AVENUE		TELEPHONE:	(408) 356-8816
CITY:	LOS GATOS	STATE: CA	ZIP CODE:	95032
CAPACITY:	50	CENSUS: 0	DATE:	08/14/2019
TYPE OF VISIT:	Case Management - Other	ANNOUNCED	TIME BEGAN:	01:50 PM
MET WITH:	Rekha Talcherkar		TIME COMPLETED:	06:30 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 (LPA) Zaid Hakim and Nancy Rodriguez conducted an Announced Case Management - Other Inspection at the facility today. Upon arrival, LPAs observed zero children currently in care as the program is currently on Summer Break and met with Ms. Rekha Talcherkar. The purpose of the inspection is to review the Licensee request to increase capacity from 50 children ages 2 years old to entry to First grade to 70 children ages 2 years old to entry to First Grade with a Toddler Option for up to 12 children ages 18 months to 30 months old. Currently, the facility is licensed to use classroom #'s 8, 12, 14, the library, and the study room. The Licensee is requesting to add classroom #13 to the existing license and will convert classroom #8 to the Toddler classroom. LPAs toured the facility inside and out and conducted measurements of all classrooms and indoor and outdoor activity areas to confirm square footage requirements. The measurements are as follows: - Classroom #8: 13.167 x 14.750 = 194.213 + 24.500 x 15.417 = 377.716 = 571.929 - Encumbered = 1.167 x 4.167 = 4.873 x 3 = 14.620 = 571.929 - 14.620 = 557.309 SQFT - Classroom #12: 20.750 x 24.333 = 504.909 + 16.750 x 24.333 = 407.577 =504.909 + 407.577 = 912.486 SQFT - Library: 14.417 x 12.750 = 183.816 SQFT - Study Room: 14.250 x 12.583 = 179.307 SQFT Report Continued on the Following 809-C dated 08/14/19: Page 2

SUPERVISOR'S NAME: Anthony Studebaker	TELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Zaid Hakim	TELEPHONE: (408) 497-9236
LICENSING EVALUATOR SIGNATURE:	DATE: 08/14/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/14/2019

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 3

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: MARIPOSA MONTESSORI SCHOOL	FACILITY NUMBER: 434404878
	VISIT DATE: 08/14/2019

NARRATIVE

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Report Continued on the Previous 809 dated 08/14/19: Page 2

Classroom #14: 25.833 x 14.250 = 368.120 + 25.833 x 14.833 = 383.180 =
368.120 + 383.180 = 751.300 SQFT

Classroom #13 (Licensee Request to Add to License): 38.667 x 24.750 = 957.008 SQFT

557.309 SQFT + 912.486 SQFT + 183.816 SQFT + 179.307 SQFT + 751.300 SQFT + 957.008 SQFT =
3,541.226 TOTAL INDOOR SQFT

Outdoor Measurements are as follows:

Rear Outdoor Play Yard
56.417 x 32 = 1,805.344 + 100 x 20.583 = 2,058.3 =
3,863.644 SQFT

Toddler / Classroom 8 Outdoor Play Yard
18.500 x 12.750 = 235.875 + 14 x 15 = 210 + 25.583 x 17.917 = 458.370 = 904.245 SQFT

Front Outdoor Play Yard
47 x 35.833 = 1,684.151 + 44.667 x 42.500 = 1,898.347 + 36 x 25.667 = 924.012 = 4,506.51 SQFT

3,863.644 SQFT + 904.245 SQFT + 4,506.51 SQFT =
9,274.399 TOTAL OUTDOOR SQFT

Report Continued on the Following 809-C dated 08/14/19: Page 2

SUPERVISOR'S NAME: Anthony Studebaker	TELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Zaid Hakim	TELEPHONE: (408) 497-9236
LICENSING EVALUATOR SIGNATURE:	DATE: 08/14/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/14/2019

LIC809 (FAS) - (06/04)

Page: 2 of 3

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: MARIPOSA MONTESSORI SCHOOL	FACILITY NUMBER: 434404878
	VISIT DATE: 08/14/2019

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Report Continued on the Following 809-C dated 08/14/19: Page 3

LPAs observed the outdoor play area to be secured with perimeter fencing and structures and supplies to be in safe condition and age appropriate. Children have access to shade and drinking water via personal water bottles. LPAs and the Director discussed children's safety as it relates to outdoor conditions such as hot weather, air quality, and natural and man-made disasters.

The Director understands the limitations and regulations regarding the Toddler Option Component, such as groups may not exceed 12, toddlers must not be commingled with other age groups, and Staff / Supervision Ratio requirements. The Director stated the facility will potty train in the Toddler classroom and children will transition when potty trained. The Toddler classroom is equipped with a changing table within arms reach of a sink.

LPAs and Facility Representatives discussed Effects of Lead in Drinking Water, Updates to the Mandated Reporter Training, Safe Sleep, Active Shooter, and other pertinent items.

The facility maintains sufficient indoor and outdoor square footage to meet the amount required for the requested capacity. Based on LPA inspection, the Licensee request to increase capacity from 50 children ages 2 years old to entry to First grade to 70 children ages 2 years old to entry to First Grade with a Toddler Option for up to 12 children ages 18 months to 30 months old is Approved pending Community Care Licensing Management Approval and Community Care Licensing receipt of the original STD 850 Fire Clearance approval.

A Notice of Site Visit has been issued and must remain posted for 30 consecutive days. No deficiencies have been issued during today's inspection. Exit interview conducted with Ms. Rekha Talcherkar.

SUPERVISOR'S NAME: Anthony Studebaker	TELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Zaid Hakim	TELEPHONE: (408) 497-9236
LICENSING EVALUATOR SIGNATURE:	DATE: 08/14/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/14/2019

LIC809 (FAS) - (06/04)

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