434411998-7-28-2021-52-CC-LDBX-C5CS3C-20210728133054

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434411998
Report Date: 07/28/2021
Date Signed: 07/28/2021 01:31:07 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:	CHILDREN'S LEARNING COTTAGE PRESCHOOL		FACILITY NUMBER:	434411998
ADMINISTRATOR:	ADELA ALVARADO		FACILITY TYPE:	850
ADDRESS:	675 ESCUELA AVENUE		TELEPHONE:	(650) 564-9906
CITY:	MOUNTAIN VIEW	STATE: CA	ZIP CODE:	94040
CAPACITY:	30	CENSUS: 26	DATE:	07/28/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Adela Alvarado		TIME COMPLETED:	02:00 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 July 28, 2021, at 10:30 AM., Licensing Program Analyst (LPA) Lorraine Dacanay Breaux and Elimika Woods conducted an unannounced Annual Required Inspection and met with Director, Adela Alvarado. LPA disclosed the purpose of the inspection and was granted entry into the facility by the Director. Present during this inspection was 3 teachers (finger print cleared staff), one 16 year old volunteer, 26 preschoolers. The center is consist of three(3) classrooms. The hours of operation are 8:00 AM- 5:30 PM, Monday -Friday CLASSROOMS: The three classrooms were inspected. Teacher child ratio was observed. There are adequate play and learning materials available. There is adequate heating/air conditioning, ventilation and lighting. The floors, furniture, and equipment are age appropriate and in good repair. Drinking water is available inside and outside of the center. There is proper individual storage space for each child. The isolation area for sick children is in the office. All children are under supervision including visual supervision by staff members. At 11:15 AM, LPA tested one carbon monoxide detector and one wired smoke detector located in all classrooms. All devices were functional. The center is equipped with a working telephone, carbon monoxide detector, pull down fire alarms and a three fully charged 3A40BC fire extinguishers. All solid waste storage containers have tight fitting covers on, and appear to be in good repair. BATHROOMS AND TOILETING AREAS: There are separate bathrooms for staff and children. Toilets and faucets are in safe and sanitary operating condition. The children are able to reach the sinks and toilets. Supplies are available to the children. -----------------------------See LIC 809 C ---------------------------

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Lorraine Dacanay-Breaux	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 07/28/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/28/2021

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: CHILDREN'S LEARNING COTTAGE PRESCHOOL	FACILITY NUMBER: 434411998
	VISIT DATE: 07/28/2021

NARRATIVE

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FOOD SERVICE AREAS: No meals provided only snacks. The menus are posted at least one week in advance, available for review and dated.

OUTDOOR PLAY AREAS: There was free standing water accessible to children for play, supervised by staff. There are age appropriate toys and materials for the children. There are play structures available to children in care. There’s a shaded rest area for children. The playground is fenced and all equipment and surfaces are free from hazards.

RECORDS: All individuals subject to criminal record review have a clearance or exemption and have been associated to the facility. Children's files and staff files were reviewed around 11:55AM. LPA reviewed the facility roster and obtained a copy. At least one opening/ closing staff member has a current CPR & First Aid Certificate. Mandated Reporter Training was discussed and certificates were reviewed. Director states that CPR and First Aid certificate will expire August 8, 2021 this is not verifiable. The center is not compliance with the sign in and out procedure. Disaster drills are being conducted at least once every 6 months in the log indicates the last one was conducted on January 28, 2021. Per director, there are no firearms stored on the premises. All required documents are posted in a public accessible area.

At 11:45 AM reviewed the sign in/out logged and only 24 children were signed in today. Confirmed with the director that two parents forgot to sign in their children .

At 12:25 PM LPA noticed that the Mandated Reporters Training was missing in all employee files. LPA asked the director about the training and the director confirm the staff has not taken the training.

HEALTH RELATED SERVICES: No IMS is being provided at this time. No medicine to be stored.

California Law requires Family Child Cares licensees to report unusual incidents or injuries to children in care to child's parents and to the Department of Social Services using the Unusual Incident/Injury form (LIC 624). Incidents must be reported within 24 hours by phone, fax, or electronic mail. Roster of the children must be properly maintained and fire/disaster drill every six months must be documented.

See 809 C

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Lorraine Dacanay-Breaux	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 07/28/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/28/2021

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: CHILDREN'S LEARNING COTTAGE PRESCHOOL	FACILITY NUMBER: 434411998
	VISIT DATE: 07/28/2021

NARRATIVE

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Director is reminded that ALL assistants, volunteers, and staff, that are 18 years of age or older must be fingerprint cleared and associated to this facility prior to being in the presence of children in care or an immediate civil penalty will be assessed from $100 to $3000 per person, per incident. Director was reminded of the responsibility as a mandated reporter. All forms can be downloaded at www.ccld.ca.gov
LPAs provided a copy of Safe Sleep in Child Care brochure, a handout "What Does A Safe Sleep Environment Look Like?," and PIN 19-06-CCP to the director.

Incidental Medical Services (IMS) policy was discussed. Per licensee, no IMS is being provided at this time. The licensee was reminded that when any changes to the IMS plan is made, an updated Plan for Providing 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.” Licensee was reminded to visit our website at www.ccld.ca.gov to get quarterly updates on new laws and regulations.

No deficiency cited during today’s visit. An exit interview was conducted with the director. The director was provided a copy of her appeal rights and the signature on this form acknowledges receipt of these rights. A Notice of Site visit was posted at the time of inspection and must remain posted for 30 days.

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Lorraine Dacanay-Breaux	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 07/28/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/28/2021

LIC809 (FAS) - (06/04)

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