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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434415084
Report Date: 02/27/2020
Date Signed: 02/27/2020 12:45:09 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:EDISON LEARNING CORP.FACILITY NUMBER:
434415084
ADMINISTRATOR:RAMIN MIRFACILITY TYPE:
850
ADDRESS:1260 ERIN WAYTELEPHONE:
(408) 559-1566
CITY:CAMPBELLSTATE: CAZIP CODE:
95008
CAPACITY:74CENSUS: DATE:
02/27/2020
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:51 AM
MET WITH:Ann DeleoTIME COMPLETED:
01:00 PM
NARRATIVE
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Licensing Program Analyst (LPA) Joe Macias conducted an unannounced Case Management Inspection. LPA Macias met with the Site Supervisor Ann Deleo, and explained the nature of today's visit. LPA Macias was present today for an unrelated reason from the case management inspection.

During today's inspection LPA Macias found two employees who are not associated to the facility license. LPA Macias explained that prior to employment or initial presence in the child care center, all employees and volunteers subject to a criminal record review shall obtain a California clearance or a criminal record exemption as required by law; or request a transfer of a criminal record clearance. The Director shall ensure all employees are cleared and associated to the facility license number.


Type A deficiency cited, civil penalty assessed, exit interview conducted, and a copy of this report was provided to the Licensee.

A NOTICE OF SITE VISIT WAS ISSUED, POSTED NEAR THE FRONT ENTRANCE TO THE HOME, AND MUST REMAIN POSTED FOR 30 CONSECUTIVE DAYS.

SUPERVISOR'S NAME: Sandy KnightTELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Joseph MaciasTELEPHONE: (408) 334-8320
LICENSING EVALUATOR SIGNATURE:

DATE: 02/27/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2020
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: EDISON LEARNING CORP.
FACILITY NUMBER: 434415084
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/27/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/28/2020
Section Cited

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Criminal Record Clearance: All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility:
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Request a transfer of a criminal record clearance as specified in Section 101170(f). This requirement was not met as evidenced by: LPA found two employees who are not associated to the facility license.
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AB633 Parent Notification is required. This page shall be provided to all parents of children currently enrolled and any future children being enrolled for the next 12 months per AB633 requirements.

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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: Sandy KnightTELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Joseph MaciasTELEPHONE: (408) 334-8320
LICENSING EVALUATOR SIGNATURE:
DATE: 02/27/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/27/2020
LIC809 (FAS) - (06/04)
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