434415262-6-4-2019-52-CC-ZHAM-BCTU5N-20190604151700

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434415262
Report Date: 06/04/2019
Date Signed: 06/04/2019 03:17:08 PM

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:	LOS ALTOS-MOUNTAIN VIEW CHILDREN'S CORNER, INC.		FACILITY NUMBER:	434415262
ADMINISTRATOR:	LAURA BERNAL		FACILITY TYPE:	850
ADDRESS:	1555 OAK AVENUE		TELEPHONE:	(650) 948-8950
CITY:	LOS ALTOS	STATE: CA	ZIP CODE:	94024
CAPACITY:	60	CENSUS: 0	DATE:	06/04/2019
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	12:55 PM
MET WITH:	Laura Bernal		TIME COMPLETED:	03:30 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) Zaid Hakim conducted an Announced Pre-Licensing Inspection at the prospective facility today. Upon arrival, LPA observed zero (0) preschool age children on site and met with Ms. Laura Bernal, Licensee Applicant Representative/ Director. The Applicant is applying for a Preschool License to serve a maximum of 60 children ages two (2) years old to entry to First Grade. The application has been submitted due to a change of location and no administrative or program changes have been made. The facility is currently operating under license #430704138 at the previous licensed location. The applicant understands that regulatory compliance with all licensing regulations and expectations must continue to be followed during this transition process. Days and hours of operation will be Monday through Friday 8:00am to 5:30pm. The facility has obtained an approved Fire Clearance from the local fire authority for a maximum capacity of 60 children dated 05/29/19. LPA notes that following this inspection, subsequent inspections from the local fire authority and Community Care Licensing may be required prior to final licensure. LPA notes the prospective facility is located on an active church campus with clear designations as to which areas are approved for facility use. Prior to this inspection, LPA agreed to conduct an inventory count of required equipment and supplies at facility license #430704138 as these items will be transferred to the new location but are currently still in use by staff and children. On 06/04/19 LPA noted the following items: at least 60 cubbies for storage of children's personal items, at least 16 tables, at least 60 chairs, at least 60 mats for napping, at least 3 changing tables, sufficient bedding and linens for 60 children, and at least 3 complete First Aid Kits. LPA also observed outdoor and indoor supplies, equipment, and toys that were age appropriate, in good condition, and in sufficient amount for 60 children. At this new location LPA observed the following: 6 sinks, 5 toilets, 1 urinal and at minimum 1 fully charged 2A10BC fire extinguisher, 1 functioning smoke detector and 1 functioning carbon monoxide detector. LPA observed a central alarm and fire detection system on site. The applicant was informed that all fire safety items should be maintained at least once every 12 months. LPA observed that staff have designated restrooms inside the facility and that the facility has door locks and barricade gates to secure certain areas. LPA observed the kitchen inside the classroom to be equipped with functional appliances. LPA observed all classrooms to be clean and safe for children. Restrooms were observed to be sanitary, functioning, and items that pose a danger to children were stored in inaccessible locations. LPA observed diaper changing supplies and hygiene equipment within arms reach of a sink and that trash receptacles have tight fitting lids. REPORT CONTINUED ON THE FOLLOWING PAGE (PAGE #2 - REPORT DATED 06/04/2019):

SUPERVISOR'S NAME: Anthony Studebaker	TELEPHONE: (408) 497-9236
LICENSING EVALUATOR NAME: Zaid Hakim	TELEPHONE: (408) 497-9236
LICENSING EVALUATOR SIGNATURE:	DATE: 06/04/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2019

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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: LOS ALTOS-MOUNTAIN VIEW CHILDREN'S CORNER, INC.	FACILITY NUMBER: 434415262
	VISIT DATE: 06/04/2019

NARRATIVE

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CONTINUATION OF PREVIOUS PAGE (PAGE #1 - REPORT DATED 06/04/2019):

The applicant stated that snacks will be served at the facility and that children's lunches will be brought from home. In the event of food not being brought from home and parents being unavailable to drop off lunch, the facility will also maintain food supplies at the facility. The applicant stated that menus will be posted and updated as needed to inform parents of what foods may be served at the facility at any given time. Applicant stated that staff will be informed and trained as necessary regarding any dietary restrictions or food allergies. LPA advised that children's physician's reports shall be current and updated as needed. Applicant stated that the facility will assist with medications at this time and maintains an Incidental Medical Services Policy in place. LPA observed there will be drinking water available for children in the classroom and outside via personal water bottles and water fountains during activity time. LPA observed floors and carpeting to be clean and free from obstruction.

The facility program does not intend on providing any transportation to children at this time and stated that there will be no off site field trips at this time. The facility will maintain an accurate roster of enrolled children. Applicant stated a written sign in / out sheet will be used and updated throughout the day containing full legal signatures of parents / responsible parties. The applicant has been informed that the department issues a waiver for electronic sign in/out systems. The facility also has a working land line phone on site.

The facility is approved to use the following areas for overall use:
Classrooms 2, 3, 4, the kitchen, the office, the staff room, restrooms next to Classrooms 2 and 4, the restroom located inside Classroom 3, and 3 separate play yards designated play yard 2, 3, and 4.

LPA conducted indoor and outdoor measurements of all approved activity areas. Measurements are as follows:

Classroom 2
28.417 x 20 = 568.34
Classroom 4
40 x 27.917 = 1,116.68
Classroom 3
23.500 x 15.083 = 354.45
+ 16 x 3.250 = 52
+12.333 x 13.417 = 165.471
+ 24.667 x 14 = 345.338

Totals: 568.34 + 1,116.68 + 354.45 + 52+ 165.471 + 345.338 =
2,602.279 divided by 25 = 74.350

REPORT CONTINUED ON THE FOLLOWING PAGE (PAGE #3 - REPORT DATED 06/04/2019):

SUPERVISOR'S NAME: Anthony Studebaker	TELEPHONE: (408) 497-9236
LICENSING EVALUATOR NAME: Zaid Hakim	TELEPHONE: (408) 497-9236
LICENSING EVALUATOR SIGNATURE:	DATE: 06/04/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2019

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: LOS ALTOS-MOUNTAIN VIEW CHILDREN'S CORNER, INC.	FACILITY NUMBER: 434415262
	VISIT DATE: 06/04/2019

NARRATIVE

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CONTINUATION OF PREVIOUS PAGE (PAGE #2 - REPORT DATED 06/04/2019):

Outdoor Measurements are as follows:

Play Yard 2: 54.667 x 21.417 = 1,170.803
Play Yard 3: 26.917 x 34.667 = 933.131 + 41.333 + 47.250 = 1,952.984 + 33.250 x 22.667 = 753.677
Play Yard 4: 41.250 x 12 = 495 + 29.667 x 18.583 = 551.301 + 75.333 x 80.333 = 6,051.725 + 22.167 x 19.750 = 437.798

Totals = 12,345.419 divided by 75 = 164. 602

In the outdoor play area LPA observed secure perimeter fencing securing the outdoor play area from the outside. Shade will be made available for children provided by umbrellas and canopies and drinking water is available to children via water bottles and drinking fountains. LPA and the applicant discussed children's safety and supervision outside and clear walkways and exit routes in the event of an emergency.

At this time, encumbered space has not been calculated into final measurements which will require a subsequent inspection prior to final licensure. Licensure is currently pending items discussed between LPA and the Director and Community Care Licensing Management approval. However, at this time, the facility maintains sufficient square footage for the requested capacity of 60 children.

The Applicant / Director has agreed to submit an updated Facility Sketch of all indoor and outdoor activity areas to reflect accurate labels classroom floor plans.

Exit Interview conducted with Ms. Laura Bernal, Applicant / Director.

SUPERVISOR'S NAME: Anthony Studebaker	TELEPHONE: (408) 497-9236
LICENSING EVALUATOR NAME: Zaid Hakim	TELEPHONE: (408) 497-9236
LICENSING EVALUATOR SIGNATURE:	DATE: 06/04/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2019

LIC809 (FAS) - (06/04)

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