434410592-5-17-2019-07-CC-MSMS-BC9SB8-20190517134331

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434410592
Report Date: 05/17/2019
Date Signed: 05/17/2019 01:43:36 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:	ORCHARD, THE		FACILITY NUMBER:	434410592
ADMINISTRATOR:	ELIZABETH "OMI" LINDSEY		FACILITY TYPE:	830
ADDRESS:	494 S. BERNARDO AVE.		TELEPHONE:	(408) 789-2621
CITY:	SUNNYVALE	STATE: CA	ZIP CODE:	94086
CAPACITY:	32	CENSUS: 29	DATE:	05/17/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	11:30 AM
MET WITH:	Elizabeth "Omi" Lindsey		TIME COMPLETED:	01:45 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 Elizabeth "Omi" Lindsey, director, for an unannounced annual/random inspection. LPA notes that the Facility is licensed in the Olive, Pomegranate, Kumquat, & Lemon Rooms. The Facility also has a preschool program (#434410591) on site and that program is licensed in the Fig, Clementine, and Nutmeg. 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. A review of staff records on May 14, 2019 indicates that all Facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. LPA reminded Omi 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. LPA reviewed ten children's and twelve staff (12 teachers) files during today's inspection. Each child's file reviewed contains the Information and Emergency Information form (LIC 700) and Needs & Services Plans. Needs & Services Plans also include individual feeding plans for each child. All eight staff files reviewed contain the required transcripts/verification of experience. All infant teachers are qualified and proof of completion of the infant/toddler course on file. All staff have the required immunization records and proof of completion of the Mandated Reporter Training for Child Care Workers on file. Omi and all teachers have current CPR and First Aid certifications on file. Omi 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. Omi understands the conditions, limitations, and capacity specifications of the Facility license. Omi understands that infants shall be visually supervised at all times and never left unattended. LPA observed 3 teachers with 7 infant children in the Olive Room, 3 teachers with 8 infant children in the Pomegranate Room, and 3 teachers with 8 infant children in the Kumquat Room, and three teachers with 6 infant children in the Lemon during today's inspection. REPORT CONTINUED ON THE FOLLOWING PAGE (PAGE #2 - REPORT DATED 05/17/2019):

SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Melvin S Matos	TELEPHONE: (408) 334-8554
LICENSING EVALUATOR SIGNATURE:	DATE: 05/17/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/17/2019

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: ORCHARD, THE	FACILITY NUMBER: 434410592
	VISIT DATE: 05/17/2019

NARRATIVE

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CONTINUATION OF PREVIOUS PAGE (PAGE #1 - REPORT DATED 05/17/2019):

LPA observed that all rooms are clean and safe for all children and staff. Omi states that the Facility has a third-party cleaning service that cleans the Facility Monday through Friday in the evenings. Omi states that the carpeting in the infant rooms is deep cleaned several times per year or more frequently if needed. Drinking water is readily available for the children in each room and in the outdoor playground area via sippy cups, bottles, and pitchers/disposable cups. LPA observed solid waste containers with tight-fitting lids in each room. 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. Omi states that there are no weapons or firearms on the premises.

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. Cleaning supplies are inaccessible to the children and stored in high cabinets inaccessible to children. Any medications at the Facility are stored in the individual classrooms inaccessible to the infant children.

LPA observed all furniture and equipment is in good condition and safe for the children. The infant changing tables have raised sides that are at least 3 inches in height and are within arm's reach of a sink. The infant changing tables have a vinyl changing pad that is at least 1 inch think and in good condition. Napping equipment is appropriate.

The playground areas utilized by infant children is surrounded by appropriate fencing and the outdoor surfaces are safe for the children. The infant playground areas are fenced and separate from the preschool playground. LPA observed that the outdoor equipment is age appropriate and in good condition. There is sufficient resilient materials in the outdoor playground areas. LPA did not observe any bodies of water.

No deficiencies issued during today's inspection.

LPA conducted an exit interview with Omi prior to the conclusion of today's inspection and discussed the upcoming regulation updates re: safe sleep. Department website for additional details: www.ccld.ca.gov.

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

SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Melvin S Matos	TELEPHONE: (408) 334-8554
LICENSING EVALUATOR SIGNATURE:	DATE: 05/17/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/17/2019

LIC809 (FAS) - (06/04)

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