434411992-8-12-2021-52-CC-MESA-C5TVNP-20210812163527

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434411992
Report Date: 08/12/2021
Date Signed: 08/12/2021 04:35:35 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:	ACHIEVING STARS ACADEMY		FACILITY NUMBER:	434411992
ADMINISTRATOR:	MICHELLE OHYE		FACILITY TYPE:	850
ADDRESS:	301 SOUTH ABBOTT AVENUE		TELEPHONE:	(408) 263-8802
CITY:	MILPITAS	STATE: CA	ZIP CODE:	95035
CAPACITY:	96	CENSUS: 10	DATE:	08/12/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	03:18 PM
MET WITH:	Michelle Ohye		TIME COMPLETED:	04:45 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	On Thursday, August 12, 2021 at 3:18 PM, Licensing Program Analyst (LPA) Manel Estoesta conducted an unannounced Required 1 Year Visit. LPA met with Director Michelle Ohye, Cristy Ackerman and explained the purpose of today's visit. Present on this visit were 3 staff and 10 preschool children in care. Facility operates from Monday to Friday 8:15 AM to 5PM. LPA toured the facility to conduct a Health and Safety inspection. LPA observed Facility’s License, Parents’ Rights Poster, Personal Rights, and Activity Schedules were observed to be posted. Facility was observed to be in compliance with teacher to children ratio requirement during LPA's inspection. Children were engaged in activities under the visual supervision of the teachers. The preschool classrooms, restrooms, kitchen, and storage room were inspected. Director stated that facility does not possess nor store any weapons on the premises. Disinfectants, cleaning solutions, and other items that are dangerous to children were stored inaccessible to children. LPA reminded facility that storage place for poisons is required to be locked up. Furniture and equipment such as mats, cots, tables, and chairs were age appropriate and were in good condition. Restrooms for children's use were observed to be in safe, sanitary, and functioning condition. Outdoor activity space is fenced and play equipment were maintained in a safe condition and free of hazards. There were no bodies of water observed. Areas around and under high climbing equipment and slides were cushioned with material that absorbs falls. There were shaded rest areas for children. Drinking water are arranged to be readily available to children during indoor and outdoor activities. Foods and beverages were kept protected against contamination and spoilage. Kitchen and food storage area were clean, free of litter, rubbish, and rodents/vermin. Trash cans for solid waste had tight-fitting covers on. LPA obtained a copy of Children's Roster. SEE LIC 809 C.....

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Manel Estoesta	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 08/12/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2021

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: ACHIEVING STARS ACADEMY	FACILITY NUMBER: 434411992
	VISIT DATE: 08/12/2021

NARRATIVE

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Children sign in and out procedures and logs were reviewed. A random sample of Children's files was selected for review. Records reviewed include Admission Agreement, Identification and Emergency Information, Medical Assessment, and Immunization

There was at least one Teacher with current certification in Pediatric CPR and First Aid present at the facility during inspection. A random sample of Staff's files was selected for review. The records reviewed include: Criminal Record and Child Abuse Index Clearance, Health Screening Report with TB Clearance, Education Qualification, records of immunization (Measles and Pertussis), and Training. Staff have their AB1207 Mandated Reporter Training Certifications in their file. LPA reminded Director that the training needs to be renewed every two years.

Facility does not provide transportation for children but Director understands that children cannot be left alone, unattended in park vehicles. First Aid Kit was inspected. Fire extinguisher was last serviced on October 2018. LPA observed that the facility has a Fire Alarm and sprinkler system. Carbon Monoxide and Smoke Detectors were observed. Facility had a Fire Inspection date of 06/2021. Fire and Earthquake Drill was last conducted in March 2021.

Director stated that facility does handle medications and is providing Incidental Medical Services – IMS: Epinephrine and Inhaled Medication. LPA reviewed storage of medication and equipment/supplies and Facility's current IMS Plan for Epinephrine, and reviewed children’s, personnel, and administrative records. For IMS information, see Evaluator Manual – Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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. An updated Plan of Operation will be submitted to Licensing Office within 15 days.

SEE 809 C.....

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Manel Estoesta	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 08/12/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2021

LIC809 (FAS) - (06/04)

Page: 2 of 3

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: ACHIEVING STARS ACADEMY	FACILITY NUMBER: 434411992
	VISIT DATE: 08/12/2021

NARRATIVE

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LPA Estoesta discussed, provided copyLead Poisoning Facts Flyer and PIN-21-21-CCP to the Director. For more information, please follow the link https://cdss.ca.gov/inforesources/child-care-licensing/water-testing-information

LPA also reviewed with Director the violations that would result in an immediate assessment of civil penalty in the amount of $500. Director is encouraged to visit the Department’s website at www.cdss.ca.gov to access resources for Providers, Title 22 Regulations, Online option to pay Annual License fees, etc.

In the areas that were evaluated no regulatory violation was observed at the time of the visit. Exit Interview was conducted, where this report was reviewed and discussed with Director.

A NOTICE OF SITE VISIT WAS ISSUE AND MUST BE POSTED ON OR ADJACENT TO THE INTERIOR SIDE OF THE MAIN DOOR INTO THE FACILITY FOR 30 CONSECUTIVE DAYS.

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Manel Estoesta	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 08/12/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2021

LIC809 (FAS) - (06/04)

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