434410818-9-27-2019-07-CC-SCRL-BGET87-20190927142951

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434410818
Report Date: 09/27/2019
Date Signed: 09/27/2019 02:29:57 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:	NELLY'S CHILDCARE AND PRESCHOOL		FACILITY NUMBER:	434410818
ADMINISTRATOR:	GREISLYE PARADA		FACILITY TYPE:	830
ADDRESS:	202-B RAILWAY AVENUE		TELEPHONE:	(408) 364-1300
CITY:	CAMPBELL	STATE: CA	ZIP CODE:	95008
CAPACITY:	10	CENSUS: 8	DATE:	09/27/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	12:16 PM
MET WITH:	Greislye Parada		TIME COMPLETED:	02:40 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), Stephanie Rangel, conducted an annual random inspection. LPA met with Site Director, Greislye Parada, and explained the nature of today's inspection. LPA observed all the required posted materials including the facility license, Notification of Parents' Rights form, Emergency Disaster Plan(LIC 610), Earthquake Preparedness Checklist(LIC 9148), Personal Rights, menus, and activity schedule. The facility operates in one infant classroom. LPA toured the facility both indoor and outdoor. LPA reviewed ten random children's files and three staff files. Site Director has current CPR and First Aid certifications with an expiration date of January 6, 2020. The teacher-child ratio was in compliance during the inspection. LPA reviewed the sign in and sign out sheets and children's roster. Drinking water is available indoor and outdoor via water pitchers and personal sippy cups. Children's breakfast, lunch and two snacks are provided by the center. Younger infants meals are provided by their family. There is adequate food for all meals. There are trash cans with tight fitting lids at the facility for the disposal of solid waste. Cleaning supplies are stored in upper shelves in the classroom inaccessible to children. LPA observed at least one functioning carbon monoxide and smoke detector. The playground area utilized by children is surrounded by appropriate fencing and the outdoor surfaces are safe. Shade is provided by trees and sail shades. PlaynPour is used as resilient material under the climbing and slide structures. REPORT CONTINUED ON THE FOLLOWING PAGE (PAGE #2 - REPORT DATED 09/27/2019):

SUPERVISOR'S NAME: Anthony Studebaker	TELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Stephanie C Rangel	TELEPHONE: (408) 334-8556
LICENSING EVALUATOR SIGNATURE:	DATE: 09/27/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2019

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 2

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: NELLY'S CHILDCARE AND PRESCHOOL	FACILITY NUMBER: 434410818
	VISIT DATE: 09/27/2019

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
26
27
28
29
30
31
32

CONTINUATION OF PREVIOUS PAGE (PAGE #1 - REPORT DATED 03/28/2017):

A review of staff records 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 Mai 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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. 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. LPA discussed policy on immunizations/shots needed before starting child care/preschool.

Facility is already giving the Effects of Lead Exposure Handout dated 1/20/19 to enrolling and re-enrolling parents or guardians.

As a result of this inspection, no deficiencies are cited.

NOTICE OF SITE VISIT WAS ISSUED AND MUST REMAIN POSTED FOR 30 DAYS.

SUPERVISOR'S NAME: Anthony Studebaker	TELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Stephanie C Rangel	TELEPHONE: (408) 334-8556
LICENSING EVALUATOR SIGNATURE:	DATE: 09/27/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2019

LIC809 (FAS) - (06/04)

Page: 2 of 2