434415122-3-12-2021-52-CC-MOTI-BZ2F22-20210312030427

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434415122
Report Date: 12/17/2020
Date Signed: 03/12/2021 03:04:45 AM

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:	BUILDING KIDZ OF MOUNTAIN VIEW		FACILITY NUMBER:	434415122
ADMINISTRATOR:	RAJESWARI SRIDHARA		FACILITY TYPE:	830
ADDRESS:	250 EAST DANA STREET		TELEPHONE:	(650) 967-8000
CITY:	MOUNTAIN VIEW	STATE: CA	ZIP CODE:	94041
CAPACITY:	42	CENSUS: 9	DATE:	12/17/2020
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Rajeswari Sridhara		TIME COMPLETED:	01:40 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 December 17, 2020 at 1:00PM, Licensing Program Analyst (LPA), Melanie Otsuji conducted a virtual inspection with Rajeswari Sridhara . The purpose of this inspection is to provide technical assistance and ensure the facility is safe for the care and supervision of children in care. Due to COVID-19 state of emergency a Licensed Child Care Center waiver was granted on 12/3/2020 for the facility to care for children ages Birth to 24 months of age at the above address due to COVID-19. Fire clearance on file. The facility is requesting to use Room 6 for toddler option. Facility is requesting to temporarily enroll toddlers aged 15 months through 36 months into the toddler option program. Check-in will take place at the entrance of the building. Authorized representative uses a QR code to sign their child in/out for the day. This electronic system records the individual logging the child in and out as well as records the time and day. The sign in/out log is printed every day . If children become ill during the day, they will rest in the isolation area located in the Director's office. The spare/authorized representative bathroom will be used for the isolation bathroom. Children’s authorized representative will be contacted immediately for pick up, if a child becomes ill. Department of Public Health will be contacted in regard to any COVID-19 illness. Children will stay with the same group as assigned and will not be moved from one group to the other. No more than 16 in a cohort and groups must be kept physically separated. Age appropriate furniture including tables and chairs and are present in each of the rooms to meet the needs of children in care. Bathrooms are located in both Room 6 and Room 5. There are 4 toilets and 2 sinks available. There is a designated outdoor play area with age appropriate equipment and activities. Drinking water readily available through the use of water bottle filling stations and water jugs.

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Melanie Otsuji	TELEPHONE: (510) 622-2613
LICENSING EVALUATOR SIGNATURE:	DATE: 12/17/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/17/2020

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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: BUILDING KIDZ OF MOUNTAIN VIEW	FACILITY NUMBER: 434415122
	VISIT DATE: 12/17/2020

NARRATIVE

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The facility will maintain children files that include emergency authorization cards and staff files that include proof of criminal background clearance. All childcare areas, including the playgrounds, will be cleaned and sanitized daily or more often as necessary following the facility’s cleaning and sanitation policies,

A health check on staff and children will be conducted each day upon arrival. LPA discussed the terms and conditions of the waiver and facility will ensure compliance with all terms and conditions of the Temporary Waiver and will adhere to Public Health guidelines and directives.

To further ensure the health and safety of the children in care, Community Care Licensing will provide on-going Technical Assistance (TA) to the facility.

Please feel free to contact the Oakland South East Child Care Office at (510) 622-2602.

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Melanie Otsuji	TELEPHONE: (510) 622-2613
LICENSING EVALUATOR SIGNATURE:	DATE: 12/17/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/17/2020

LIC809 (FAS) - (06/04)

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