434408057-10-11-2021-07-CC-OCAO-C7PRB7-20211011125215

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434408057
Report Date: 10/11/2021
Date Signed: 10/11/2021 12:52:23 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:	MULBERRY SCHOOL		FACILITY NUMBER:	434408057
ADMINISTRATOR:	KAREN JARRETT		FACILITY TYPE:	850
ADDRESS:	220 BELGATOS ROAD		TELEPHONE:	(408) 358-9080
CITY:	LOS GATOS	STATE: CA	ZIP CODE:	95032
CAPACITY:	45	CENSUS: 25	DATE:	10/11/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:10 AM
MET WITH:	Amy Moreno		TIME COMPLETED:	01:00 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 Analysts (LPAs) Ofelia Calivo and Mel Matos met with Amy Moreno, Director, for an unannounced Required - 1 Year inspection. LPAs toured the indoor and outdoor areas of the Facility with Amy during today's inspection. LPAs 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. Days and hours of operation are Monday through Friday 8:00am to 4:30pm. The facility is licensed to serve a maximum of forty-five (45) children ages two to five years old in Rooms #1 & #2. A review of staff records on October 11, 2021 indicates that all Facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. LPAs reminded Amy 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. LPAs reviewed ten children's and eight staff files (1 director & 7 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. All staff have current CPR and First Aid certifications on file. Amy 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). LPAs observed that the teacher/child ratio was in compliance during today's inspection. LPAs observed 9 children in Room 2 with two teachers and 16 children in Room 1 with three teachers during today's inspection. Amy understands the conditions, limitations, and capacity specifications of the Facility license. Amy understands that children shall be visually supervised at all times. Any child(ren) who exhibit symptoms of illness including, but not limited to, fever or vomiting, are not accepted in care. Any child(ren) who become ill during the day, shall be isolated in the director’s office area.

SUPERVISOR'S NAME: Diana Stephenson	TELEPHONE: (408) 324-2128
LICENSING EVALUATOR NAME: Ofelia Calivo	TELEPHONE: (408) 334-8551
LICENSING EVALUATOR SIGNATURE:	DATE: 10/11/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2021

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: MULBERRY SCHOOL	FACILITY NUMBER: 434408057
	VISIT DATE: 10/11/2021

NARRATIVE

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LPAs observed that the Facility is clean, safe, sanitary, and in good repair for children, staff, and visitors. Amy states that the Facility has a third-party cleaning service that cleans the Facility Monday through Friday in the evenings. Amy understands that the Facility must be kept free of flies and other insects & rodents. LPAs 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 Room and in the outdoor playground area via water bottles/pitchers/disposable cups. 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. Amy states that there are no weapons or firearms on the premises. The Facility has functioning carbon monoxide detectors in each Classroom.

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 only provides PM snack to the children. Parents provide AM snack and lunches for the children. The Facility has trash cans with tight fitting lids for solid waste in each Room. Cleaning supplies are inaccessible to the children and stored in high cabinets inaccessible to children. LPAs observed a complete First Aid kit in each Room. Any medications at the Facility are individually stored in each individual Room.

The playground area utilized by children is surrounded by appropriate fencing and the outdoor surfaces are safe for the children. LPAs observed that the outdoor equipment is age appropriate and in good condition. Shade is provided by trees, umbrellas, and building overhang in the playground. There is sufficient resilient materials (wood chips) in the outdoor playground area. LPAs did not observe any bodies of water.

This facility is not providing Incidental Medical Services – IMS at this time. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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

LPAs conducted an exit interview with Amy 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) 324-2128
LICENSING EVALUATOR NAME: Ofelia Calivo	TELEPHONE: (408) 334-8551
LICENSING EVALUATOR SIGNATURE:	DATE: 10/11/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2021

LIC809 (FAS) - (06/04)

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