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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434411986
Report Date: 06/29/2021
Date Signed: 06/29/2021 05:42:19 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:KIDDIE ACADEMY OF MOUNTAIN VIEWFACILITY NUMBER:
434411986
ADMINISTRATOR:LINDA WHITEFACILITY TYPE:
830
ADDRESS:205 EAST MIDDLEFIELD ROADTELEPHONE:
(650) 960-6900
CITY:MOUNTAIN VIEWSTATE: CAZIP CODE:
94043
CAPACITY:42CENSUS: DATE:
06/29/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:51 PM
MET WITH:Rochelle WestmorelandTIME COMPLETED:
05:45 PM
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On 06/29/21, Licensing Program Analyst (LPA) James Sampair conducted an unannounced random annual site inspection of this facility beginning at 1:51PM. Upon arrival, LPA met with Director Rochelle Westmoreland. Ms. Westmoreland directed a tour for LPA Sampair through all areas of the facility inside and outside. Present at the facility were 3 teaching staff (all Fully Qualified Teachers) who cared for 7 children in the Jellyfish Room. The facility was within capacity, as is the Teacher-Child Ratio. All of the children are being supervised and all of the staff present are background cleared and associated with this facility.

The furnishings and equipment are age-appropriate and free of broken or sharp pieces. Counters and surfaces, including floors, are free of toxins. The facility provides both lunches and snacks for the children that are prepared in the Kitchen, which was clean and organized. There are no hazardous items or toxins observed to be accessible to the infants in care. The facility had sufficient infant napping equipment for each infant that was free from all loose articles and objects, including blankets and pillows, nor were there objects hanging above or attached to the side of the crib.

There are no pools or other bodies of water accessible to children. There are fully charged fire extinguishers in each of the classrooms and the facility has centralized fire alarm system with integrated carbon monoxide in each room. Per Ms. Westmoreland, there are no firearms present or stored on the premises. 3 children's files were reviewed and they were complete. 2 staff records were reviewed and they were complete. More than one staff member present has current CPR/First Aid certification. All required postings were present.
SUPERVISOR'S NAME: Jason JangTELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: James SampairTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 06/29/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2021
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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: KIDDIE ACADEMY OF MOUNTAIN VIEW
FACILITY NUMBER: 434411986
VISIT DATE: 06/29/2021
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This facility provides Individual Medical Services (IMS). LPA reviewed storage of medication, equipment, and supplies, and they were found to be handled in accordance with regulations. For IMS information, see Evaluator Manual-Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. The following information was provided: US Department of Justice (USDOJ) toll-free Americans with Disabilities Act (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.

Facility Staff are encouraged to visit www.ccld.ca.gov for licensing updates and forms. Contact ChildCareAdvocatesprogram@dss.ca.gov to sign up for quarterly updates. Staff are also reminded that mandated reporter training is required for all staff and is to be renewed every 2 years at www.mandatedreporterca.com. Facility administrator was provided with CDSS Effects of Lead Exposure Informational and lead testing requirements were discussed.

No deficiency cited during today’s visit. The appeals rights and a notice of site visit were provided that is to be posted for 30 days. A copy of this report was provided and is to be kept in the facility records for a period of three years.
SUPERVISOR'S NAME: Jason JangTELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: James SampairTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 06/29/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2021
LIC809 (FAS) - (06/04)
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