434408763-6-9-2021-07-CC-AMOS-C3TLML-20210609085251

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434408763
Report Date: 06/07/2021
Date Signed: 06/09/2021 08:53:04 AM

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:	BOWERS CHILD DEVELOPMENT INFANT PROGRAM		FACILITY NUMBER:	434408763
ADMINISTRATOR:	ROSALINDA FLORES		FACILITY TYPE:	830
ADDRESS:	2755 BARKLEY AVENUE		TELEPHONE:	(408) 423-1115
CITY:	SANTA CLARA	STATE: CA	ZIP CODE:	95051
CAPACITY:	12	CENSUS: 0	DATE:	06/07/2021
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	09:45 AM
MET WITH:	Anita Flores and Rosie Flores		TIME COMPLETED:	05:05 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 Anna Morales and Stephanie Collins conducted a Scheduled Case Management Visit and were greeted by Anita E.V. Kinney, Program Specialist Family Child Education, Santa Clara Unified School District and .Rosie Flores, Site Supervisor The Facility is currently licensed on the campus on Bowers Elementary Schools in Room 25,26,27, E and F. The facility has submitted a request to relocate from Room F to Room 23 for the Infant Program, and Room E to Room 22, ( Preschool Program, 430710433). LPA's toured each of the rooms and took measurements during today's visit. A Fire Clearance was received from the Santa Clara Fire Department 4/28/2021. The indoor measurement are as followed: Infant Classroom areas, ROOM 23 =(Total sq. ft)- (Total Encumbered Space) 19x 23=437 sq ft - 136.27=300.73 10.017x13.67= 130.89+ 300.73=431.62 divided by 35 = 12 Total Infant Indoor Activity Space (431.62 sq ft) divided by 35 sq ft= 12 infant children. Infant Playground area =(Total sq. ft) 1,931.86sq. ft Total Outdoor Infant Activity Space= 1,931.86 divided by 75= 25 infants Continue on page 2

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Anna Morales	TELEPHONE: (408) 334-8325
LICENSING EVALUATOR SIGNATURE:	DATE: 06/07/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2021

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: BOWERS CHILD DEVELOPMENT INFANT PROGRAM	FACILITY NUMBER: 434408763
	VISIT DATE: 06/07/2021

NARRATIVE

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The classroom has one toilet for staff and two sinks. The changing table is in arm's reach with a sink. There are cubbies for each of the infants personal belongings. There is a washer and dryer inside the bathroom. There is a refrigerator which is used to store the infants perishables and a plastic storage box with each of the children's names on them. The trash bins have tight fitted lids. All of the disinfectants and toxic materials are stored inaccessible to the children. Observed a fully charged 2A; 10BC fire extinguisher. in the front area of the classroom. The Carbon monoxide is interconnected with the Emergency Fire Alarm. LPA's were informed that the parents use a electronic sign/sign out. 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), and Activity Schedules is posted in the front of the classroom. LPA observed bathroom to have COVID postings and paper towels accessible.

LPA's observed four cribs and mats. The cribs are separated by safety gate. The Isolation area will be inside the teacher's area inside the front of the classroom. Observed age appropriate furnishings.

LPA's observed a secured fenced playground Shade is equipped by a canopy. Age appropriate play structure is equipped with resilient material. Observed water fountains.

This facility is licensed through Santa Clara Unified school District and all staff are fingerprinted through School District.

No deficiencies cited during today's visit.

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

Approval pending on Final review.

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Anna Morales	TELEPHONE: (408) 334-8325
LICENSING EVALUATOR SIGNATURE:	DATE: 06/07/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2021

LIC809 (FAS) - (06/04)

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