434415594-10-30-2020-07-CC-MSMS-BUVS28-20201030132907

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434415594
Report Date: 10/30/2020
Date Signed: 10/30/2020 01:29:40 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:	PRECIOUS MOMENTS PRESCHOOL LLC		FACILITY NUMBER:	434415594
ADMINISTRATOR:	CATALINA SIRI		FACILITY TYPE:	850
ADDRESS:	830 WEST EVELYN AVENUE		TELEPHONE:	(408) 685-2261
CITY:	SUNNYVALE	STATE: CA	ZIP CODE:	94086
CAPACITY:	30	CENSUS: 0	DATE:	10/30/2020
TYPE OF VISIT:	Case Management - Other	ANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Priyanka Bansal		TIME COMPLETED:	12:30 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) Mel Matos conducted an announced case management tele-inspection (via FaceTime) today. LPA met with Priyanka Bansal, Licensee representative, and explained the nature of today's inspection to her. The Licensee representative has applied for a toddler option component (ages 18 to 36 months - capacity of 10) under the current preschool license. Preschool capacity will be 20. Hours of operation: 7:30 AM to 6 PM Monday to Friday. The indoor and outdoor areas of the Facility were measured by LPA Matos on February 27, 2020 and remain unchanged per Priyanka Bansal, Licensee representative. INDOOR MEASUREMENTS ARE AS FOLLOWS: Orange Room: 25.917 x 12.667 = 328.290 Green Room: (18.167 x 12.500 = 227.087) + (9.083 x 12.500 = 113.537) + (5,250 x 4.750 = 24.937) = 365.561 Toddler Room (formerly Brown Room): 18.750 x 19.000 = 356.250 *TOTAL INDOOR SPACE: 1,050.101 sq. ft. divided by 35 = 30 preschool children* There is sufficient sinks, toilets, chairs, tables, cubbies and equipment for the children within the Facility. The playground measurements remain unchanged. Priyanka understands that the toddler option and preschool children cannot be commingled and that the Facility must follow the appropriate ratios for the toddler option and preschool children.

SUPERVISOR'S NAME: Diana Stephenson	TELEPHONE: (408) 324-2158
LICENSING EVALUATOR NAME: Melvin S Matos	TELEPHONE: (408) 334-8554
LICENSING EVALUATOR SIGNATURE:	DATE: 10/30/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2020

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: PRECIOUS MOMENTS PRESCHOOL LLC	FACILITY NUMBER: 434415594
	VISIT DATE: 10/30/2020

NARRATIVE

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OUTDOOR MEASUREMENTS ARE AS FOLLOWS:

Playground: (19.833 x 21.000 = 416.493) + (32.667 x 14.833 = 484.549) + (18.500 x 3.500 = 64.750) + (37.667 x 4.250 = 160.084) = 1,125.876

TOTAL OUTDOOR SPACE: 1,125.876 sq. ft. divided by 75 = 15 children

LPA observed that preschool playground is surrounded by appropriate fencing. There is an active waiver on file for the playground space. The playground equipment is age appropriate and rubbing padding is used as resilient materials around the secure play structure. Shade is provided by and building overhangs and trees throughout the playground. There are adequate equipment, supplies, and toys for children outdoors. LPA did not observe any bodies of water during today's inspection.

LPA received a fire clearance approval from the Sunnyvale Department of Public Safety for 30 children, including the toddler option, was received prior to today's inspection.

Priyanka was informed that due to the current COVID-19 pandemic and "Shelter In Place" Order, today's report (Facility Evaluation Report - LIC 809) will be emailed to her (email: priyaspreciousmoments@gmail.com with "Read Receipt" notification. Priyanka understands that her response to the email is considered an acknowledgement of "receipt" of today's report.

LPA conducted an exit interview with Priyanka prior to the conclusion of today's inspection and advised her that a license for 30 children (including toddler option for 10 children) will be approved upon completion of the following:

1) Acknowledgement of "receipt" of today's report has been received by LPA Matos

SUPERVISOR'S NAME: Diana Stephenson	TELEPHONE: (408) 324-2158
LICENSING EVALUATOR NAME: Melvin S Matos	TELEPHONE: (408) 334-8554
LICENSING EVALUATOR SIGNATURE:	DATE: 10/30/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2020

LIC809 (FAS) - (06/04)

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