434414643-6-14-2021-07-CC-DMAC-C3YMB5-20210614092722

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434414643
Report Date: 05/21/2021
Date Signed: 06/14/2021 09:27:47 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:	EARLY CHILDHOOD LEARNING ACADEMY		FACILITY NUMBER:	434414643
ADMINISTRATOR:	ADIDI BOUZIDA		FACILITY TYPE:	850
ADDRESS:	1919 GUNSTON WAY		TELEPHONE:	(408) 314-7060
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95124
CAPACITY:	28	CENSUS: 0	DATE:	05/21/2021
TYPE OF VISIT:	Case Management - Licensee Initiated	ANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Adidi Bouzida, Owner/Site Director		TIME COMPLETED:	02:30 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	Licensing Program Analyst (LPA) Dung Mac conducted an announced case-management tele-inspection via video conference call (FaceTime) with Owner/Site Director, Adidi Bouzida. Facility submitted the application to the Department on March 10, 2021. A fire safety inspection request approval was received from the San Jose Fire Department on May 6, 2021. The facility operates on a campus with other licensed programs that are unaffiliated. The tele-inspection is in response to facility’s request to increase the capacity from 28 to 45 by adding a new room (Room C) to their existing license. Room 1 is currently licensed, serving children ages 2-6 years old. LPA observed that Room 1 was divided into Rooms A & B and each has its own entrance and exit door. During today’s video conference call, the measurements of Rooms A, B, and C were taken by Owner/Site Director, Adidi Bouzida, and a facility staff as LPA observed the measuring process and provided direction via FaceTime (video call). INDOOR MEASUREMENTS: Room A: 20.167 x 24.833 = 500.810 Room B: 19.791 x 24.833 = 491.47 Room C: (18.000 x 46.083) minus (5.500 x 7.000 + 4.750 x 1.208) (encumbered) = 785.250 TOTAL INDOOR SPACE ACTIVITY: *(1,777.53 sq. ft) divided by (35 sq. ft. / child) = 50 children*

SUPERVISOR'S NAME: Diana Stephenson	TELEPHONE: (408) 324-2158
LICENSING EVALUATOR NAME: Dung Mac	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR SIGNATURE:	DATE: 05/21/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2021

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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: EARLY CHILDHOOD LEARNING ACADEMY	FACILITY NUMBER: 434414643
	VISIT DATE: 05/21/2021

NARRATIVE

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Facility has 3 toilets (45) and 4 sinks (60) available for the children to use. There are 12 tables, 47 chairs, 48 cubbies, and 45 cots. LPA observed a trash can with tight-fitting lid in each room. Disinfectants, cleaning solutions, and all other items that are dangerous to children are kept on high shelves inaccessible to children. First aid supplies are stored inaccessible to children. Staff bathroom is located in the church.

Adidi states that there were no changes to the layouts of the playgrounds since the Pre-licensing inspection on 9/19/2016; therefore, the outdoor space was not measured during today's tele-inspection.

OUTDOOR MEASUREMENTS:

99.417x 45 = 4,473.765 minus 90.846 (encumbered) = 4,382.919

TOTAL OUTDOOR SPACE: 4,382.919 sq. ft divided by 75 = 58 children

The playground is enclosed by a fence and is exclusively used by the Early Childhood Learning Academy. LPA observed a play structure, sandbox, and locked storages. No bodies of water were observed. Shade is provided by trees, umbrellas, and porch.

LPA advised Adidi that due to the COVID-19 pandemic and "shelter in place" order, today's report will be emailed to her (email: ecla.admission@gmail.com) with "Read Receipt" notification. Adidi understands that her reply to the email will serve as acknowledgement that the report was received.

LPA conducted an exit interview and advised Adidi that a license for 45 Preschool children will be submitted for the final stage of review upon receiving of Acknowledgement of "receipt" of today's report.

SUPERVISOR'S NAME: Diana Stephenson	TELEPHONE: (408) 324-2158
LICENSING EVALUATOR NAME: Dung Mac	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR SIGNATURE:	DATE: 05/21/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2021

LIC809 (FAS) - (06/04)

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