434415440-9-15-2021-07-CC-SYIP-C6VV2P-20210915160326

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434415440
Report Date: 09/15/2021
Date Signed: 09/15/2021 04:03:32 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:	CUSD - MUIR CUPERDOODLE PRESCHOOL		FACILITY NUMBER:	434415440
ADMINISTRATOR:	MICHELLE HERRIAGE		FACILITY TYPE:	850
ADDRESS:	6560 HANOVER DRIVE		TELEPHONE:	(408) 252-3000
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95129
CAPACITY:	42	CENSUS: 43	DATE:	09/15/2021
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	09:25 AM
MET WITH:	Alice Chan		TIME COMPLETED:	12:15 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 Analysts (LPAs) Samantha Yip and Marilou Monico conducted an unannounced Case Management- Licensee Initiated. LPAs met with Director Alice Chan and explained the reason for the inspection. The purpose of this inspection is facility is requesting to increase their capacity for 84 and adding Room 26 & Room 27. LPAs observed that they used the facility was using Room 26 and Room 27. Facility is currently licensed for Room 29 and Room 30. LPAs discussed with Director Alice Chan that facility cannot use rooms until they are licensed. Present during today's inspection were 43 children. A fire clearance for 84 was granted on 07/30/2021 for Room 26, 27, 29, and 30. LPAs measured the Room 26, Room 27, and outdoor area. The measurements are as followed: Room 26: 27.083 x 13.750= 372.391 + 25.333 x 23.583 = 597.428 = 969.819 969.819 divided by 35 = 27 children Room 27: 23.583 x 25.250 = 595.470 + 27.167 x 13.833 = 375.386 = 970.856 970.856 divided by 35 = 27 children Room 29 and Room 30 were measured on 07/31/2018. The measuring are as followed: Room 29 : 37.08 x 22.92 = 849.8736 - 123.04 = 726.83 Room 30: 37.08 x 22.92 = 849.8736 - 123.04 = 726.83 TOTAL INDOOR SPACE= 3,394.345 Divided by 35 = 96 children The outdoor measurements are as followed: Grass Area: 56.083 x 29.417 = 1649.793 Blacktop and Playground Area: 94.083 x 46.167 = 434.529 + 4.167 x 9 = 337.503 1649.793 + 337.503 = 6030.825 Total Outdoor Activity= 6030.825 divided 75 = 80 children ---------------------CONTINUES ON 809 DATED 09/15/2021 PAGE 2----------------------------

SUPERVISOR'S NAME: Anthony Studebaker	TELEPHONE: (408) 324-2148
LICENSING EVALUATOR NAME: Samantha Yip	TELEPHONE: (408) 529-8128
LICENSING EVALUATOR SIGNATURE:	DATE: 09/15/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2021

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: CUSD - MUIR CUPERDOODLE PRESCHOOL	FACILITY NUMBER: 434415440
	VISIT DATE: 09/15/2021

NARRATIVE

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---------------------CONTINUATION OF 809 DATED 09/15/2021 PAGE 1-------------------------

LPAs observed that there were 6 sinks, 4 toilets, 56 cubbies, 22 mats, 8 tables, and 38 chairs in Room 26 and Room 27. Director Alice stated that they put in an order for more mats. LPA received receipt of order placed for mats. LPA observed that invoice was for 7 additional mats order. Director stated that they will only have 39 full time children. Director understands that the facility needs to have one napping for each child. There is sufficient amount of toys for children in care. All meals and snacks are prepared by the school district or from home. Drinking water is provided through water coolers, water fountains, and individual water bottles. LPA reminded staff that all cleaning supplies need to be inaccessible to children.

The facility has a waiver to share the outdoor area. Area around the play structure has resilient material. Shaded rest area is provided through canopy. LPAs observed that the grass was overgrown and there are weeds growing. Director Alice Chan stated that she will have a work order to have the grass area maintained. She stated that will send proof that the weeds were cut. LPAs also discussed with Director Alice Chan the requires for square footage outside, which is 75 square foot per child. Since the facility is requesting a capacity of 84, the facility would need to submit a waiver request.

All staff are fingerprints through the CUSD. Therefore, all criminal records are monitored and maintained through the school district.

LPAs discussed with Director Alice Chan that a license for 84 children and usage of Room 26 and Room 27 will be approved and licensed upon approval of Licensing Program Manager approval and completion of the following:
- proof that grass area was maintained
- waiver request for outdoor square footage with daily schedule of the classrooms

As a result of this inspection, no deficiencies were cited. An exit interview was conducted where this report was discussed and provided to Director Alice Chan. A Notice of Site Visit has been issued and must be posted for 30 days.

SUPERVISOR'S NAME: Anthony Studebaker	TELEPHONE: (408) 324-2148
LICENSING EVALUATOR NAME: Samantha Yip	TELEPHONE: (408) 529-8128
LICENSING EVALUATOR SIGNATURE:	DATE: 09/15/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2021

LIC809 (FAS) - (06/04)

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