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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434412402
Report Date: 11/08/2019
Date Signed: 11/08/2019 04:06:30 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:SCUTTLEBUGS CHILD DEVELOPMENT CENTERFACILITY NUMBER:
434412402
ADMINISTRATOR:EUNICE KIMFACILITY TYPE:
830
ADDRESS:3291 STEVENS CREEK BLVDTELEPHONE:
(408) 564-5356
CITY:SAN JOSESTATE: CAZIP CODE:
95117
CAPACITY:38CENSUS: 24DATE:
11/08/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Linda WhiteTIME COMPLETED:
03:42 PM
NARRATIVE
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This inspection was completed n 10/23/19 but due to a technical issue "Type of visit " was listed as case management instead of annual/random. No changes were made to the report. Unannounced random visit made by Analyst Mahvash Behbood. Met Linda White, Site Supervisor, present also were infants 28 infant & toddler with 7 staff. Operation hours is M-F from 7 AM to 6 PM. Indoor and outdoor of the facility was toured.

Menu, licenses, Personal Rights & Parent's Rights are all posted.
Sample of staff files were reviewed. Sample files contain staff educational background, current pediatric 1st aid/CPR, immunization records and certificate of Child Abuse Reporter Training. Teacher/infant ratio was met during the visit.
A sampling of children's files were reviewed & are complete.
Not all Needs & Services plans are updated quarterly as required. .
1st aid supplies are complete. There are no medications at the Center for any of the infants. Ms. understands If/ when medication is accepted to administer by center all medication must be in their original container accompanied by parent's and physician's permission/direction in addition to the mediation log
Changing tables are within arms reach of a sink, have raised sides & a vinyl pad. Changing tables have spray bottles with disinfectant solution. There are 11 cribs in the classroom, when crib is shared before sharing the bedding is changed. Infants have age appropriate toys/equipment including feeding chairs. Center provide all formula/food and diapers, and bottles. Bottles are disinfected after each use. Sippy cups & bottles are used for drinking water. Infants on solid food are served the same food on the menu. Menu is posted & has the required food groups. Kitchen appears clean. All food is covered & there is a trash can with a tight-fitting cover. All infants were visually supervised during the visit. Infant/to
playgrounds has artificial grass for cushioning. There are plenty of safe and age appropriate toys and play equipment. Parents sign in and out electronically.
Please see next page for citation under Title 22.
SUPERVISOR'S NAME: Anthony StudebakerTELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Mahvash BehboodTELEPHONE: (408) 334-8552
LICENSING EVALUATOR SIGNATURE:

DATE: 11/08/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2019
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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/08/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/01/2019
Section Cited

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Modifications to Infant Needs and Services Plan - The written infant needs and services plan shall be updated at least quarterly, or as often as necessary to assure its accuracy. At least 5 children didn't have updated needs and service plan. This is potentially dangerous to health and safety of children,

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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Anthony StudebakerTELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Mahvash BehboodTELEPHONE: (408) 334-8552
LICENSING EVALUATOR SIGNATURE:
DATE: 10/23/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/08/2019
LIC809 (FAS) - (06/04)
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