434412402-6-26-2019-07-CC-SRED-BDHPET-20190626111538

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434412402
Report Date: 06/26/2019
Date Signed: 06/26/2019 11:15:49 AM

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:	SCUTTLEBUGS CHILD DEVELOPMENT CENTER		FACILITY NUMBER:	434412402
ADMINISTRATOR:	EUNICE KIM		FACILITY TYPE:	830
ADDRESS:	3291 STEVENS CREEK BLVD		TELEPHONE:	(408) 564-5356
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95117
CAPACITY:	38	CENSUS: 0	DATE:	06/26/2019
TYPE OF VISIT:	Office	UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Sam Penman & Geoffrey Penman		TIME COMPLETED:	11:20 AM

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 Manager (LPM), Sandy Knight and Licensing Program Analyst (LPA), Shannel Brown met with Licensee representatives, Sam Penman and Geoffrey Penman at the San Jose Regional Office for a scheduled Informal Meeting. The purpose of today’s meeting is to discuss compliance and ability to follow Title 22 Regulations as it relates to supervision. This Informal Meeting is a direct result the following Type A citation, dated on April 24, 2019 that was issued as a result of a Complaint investigation regarding an allegation that the facility staff failed to provide adequate supervision for the infants in care. During this investigation, interviews conducted with staff and parents indicated that an infant child was able to walk out of the infant classroom and into the hallway near the preschool bathroom without an infant teacher's supervision. The child was returned to the Infant teachers by a passing preschool teacher. This poses an immediate risk to the children in care. 101229(a)(1) Care and Supervision: No child(ren) shall be left without the supervision, including visual observation, of a teacher at any time except as specified in sections 101216.2(e)(1) and 101230(c)(1), was cited. The Plan of Correction (POC) for Care and Supervision was received by CCL on 04/25/19. Facility Staff will remind parents to close the door before and after entering the classroom and that he facility has also installed an auto closing child proof gate right by the main entrance of the infant room. REPORT CONTINUED ON THE FOLLOWING PAGE (PAGE #2 - REPORT DATED 06/26/19):

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Shannel Reed	TELEPHONE: (408) 489-9484
LICENSING EVALUATOR SIGNATURE:	DATE: 06/26/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2019

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: SCUTTLEBUGS CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 434412402
	VISIT DATE: 06/26/2019

NARRATIVE

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CONTINUATION OF PREVIOUS PAGE (PAGE #1 - REPORT DATED 06/26/19):

LPM, Sandy Knight explained the informal meeting and the administrative process. Licensee representatives, Sam Penman and Geoffrey Penman were advised that continued non-compliance with Title 22 Regulations could result in their license being referred to CCL's legal department for review and possible action against the license. This facility will be monitored more frequently.

Assembly Bill 633 (Child Care Parent Notification Requirements) and Acknowledgement of Receipt of Licensing Reports (LIC9224) was also explained and Provided to Licensees during today’s meeting.

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Shannel Reed	TELEPHONE: (408) 489-9484
LICENSING EVALUATOR SIGNATURE:	DATE: 06/26/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2019

LIC809 (FAS) - (06/04)

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