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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434408057
Report Date: 09/28/2022
Date Signed: 09/28/2022 11:06:14 AM


Document Has Been Signed on 09/28/2022 11:06 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131



FACILITY NAME:MULBERRY SCHOOLFACILITY NUMBER:
434408057
ADMINISTRATOR:AMY MORENOFACILITY TYPE:
850
ADDRESS:220 BELGATOS ROADTELEPHONE:
(408) 358-9080
CITY:LOS GATOSSTATE: CAZIP CODE:
95032
CAPACITY:45CENSUS: 16DATE:
09/28/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Mercedes MendozaTIME COMPLETED:
11:15 AM
NARRATIVE
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On September 28th, 2022 at 8:30am, Licensing Program Analyst (LPA) Kassandra Medrano met with Mercedes Mendoza, Director, for an unannounced required – 1-year annual inspection. LPA toured the indoor and outdoor areas of the Facility during today's inspection. 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. Days and hours of operation are: 8am-4:30pm, Monday through Friday. The preschool age program is Licensed in Rooms 1 and 2 of wing 2 on Mulberry schools private school campus. Mulberry Schools rents the campus from Union School District. LPA reviewed ten children's and 6 staff files during today's inspection. Each child's file reviewed contains the required documents, including the Information and Emergency Information form (LIC 700) and immunization records. All staff files reviewed contain the required documents, including 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. Last fire/disaster drill was completed on 09/20/2022. The staff files that were reviewed have current CPR and First Aid certifications on file. Director 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. Director understands the conditions, limitations, and capacity specifications of the Facility license. Director understand 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 school's main office area. LPA observed that the Facility is clean, safe, sanitary, and in good repair for children, staff, and visitors. The Facility has adequate ventilation, including central air conditioning/heating. Director 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 the Facility and in the outdoor playground area via filtered water jugs and individual water bottles.
SUPERVISOR'S NAME: Diana StephensonTELEPHONE: (408) 324-2128
LICENSING EVALUATOR NAME: Kassandra MedranoTELEPHONE: (408) 497-7322
LICENSING EVALUATOR SIGNATURE:
DATE: 09/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/28/2022
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
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: MULBERRY SCHOOL
FACILITY NUMBER: 434408057
VISIT DATE: 09/28/2022
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Staff and children's bathrooms are clean, sanitary, and operable. Director states that there are no weapons or firearms on the premises. The Facility has functioning carbon monoxide detectors in the Facility. The food preparation and storage areas are clean, free of litter & rubbish, and free of rodents and other vermin. The parents provide snacks and lunches for the children. The Facility has trash cans with tight fitting lids for solid waste. Cleaning supplies are inaccessible to the children and stored in high cabinets inaccessible to children. Director states that there are no poisons in the Facility/ are stored: Locked cabinets. Director understands that smoking is not allowed on the Facility premises. This facility provides IMS. A review of storage of medications, equipment and supplies, and reviewed children, personnel and administrative records. Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.
To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication. 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 building overhangs in the playground. LPA did not observe any bodies of water. Director states that the Facility does not provide transportation. Mercedes Mendoza, director, was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.
To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.
During today's visit, director had to leave for an appointment and was unable to sign. Facility representative and head of Mulberry Schools, Kara Riordan was able to sign the document.
Exit interview conducted and report was reviewed with the Director, Mercedes. No deficiencies cited during today's inspection. A notice of site visit was given and must remain posted for 30 days.
SUPERVISOR'S NAME: Diana StephensonTELEPHONE: (408) 324-2128
LICENSING EVALUATOR NAME: Kassandra MedranoTELEPHONE: (408) 497-7322
LICENSING EVALUATOR SIGNATURE:

DATE: 09/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2022
LIC809 (FAS) - (06/04)
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