434415740-5-27-2022-07-CC-JGSS-CETV7V-20220527161147

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434415740
Report Date: 05/27/2022
Date Signed: 05/27/2022 04:12:00 PM

Document Has Been Signed on 05/27/2022 04:12 PM - It Cannot Be Edited

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:	SPRINGBRIDGE INTERNATIONAL SCHOOL, LLC		FACILITY NUMBER:	434415740
ADMINISTRATOR:	REGAN, ROBERT		FACILITY TYPE:	850
ADDRESS:	1625 WEST CAMPBELL AVENUE		TELEPHONE:	(408) 477-5922
CITY:	CAMPBELL	STATE: CA	ZIP CODE:	95008
CAPACITY:	86	CENSUS: 44	DATE:	05/27/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:45 AM
MET WITH:	Tomoko Regan		TIME COMPLETED:	04:20 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), James Santos conducted an unannounced Required 1 Year inspection visit today. LPA met with Licensee/Teacher, Tomoko Regan and discussed the purpose of the visit. Licensee/Director Robert Regan was not present during today's visit. The Center's operation days and times are Monday through Friday from 8:00AM to 6:00PM. Children and teachers were engaged in different activities upon LPA's arrival. LPA observed that the teacher/child ratio was in compliance during today's inspection. LPA toured the center with Tomoko Regan. LPA observed the required posted materials including the Facility License, Emergency Disaster Plan (LIC 610), Earthquake Preparedness Checklist (LIC 9148), Parents' Rights Poster (PUB 393), Personal Rights (LIC 613A), Child Car Seat Law (PUB 269) and Activity Schedule are posted. The classroom areas were observed to be clean and in good order. There are adequate supplies, play equipment and toys for children. Children's restrooms are clean and in good operating condition. The center has fire extinguishers and alarm, smoke and carbon monoxide detectors and first aid kit. Disinfectants, cleaning solutions and other chemical items and sharp objects are stored in the closet and inaccessible to children. Per staff, they do not have poisons, weapons and ammunition on the premises and they do not provide transportation to children. The center does not provide meals to the children. The children bring their snacks and lunches from home and are stored in their lunch bags. Some of the children also uses lunch service. There are cubbies for children to store their belongings. The outside playground area is surrounded by appropriate fencing. The playground equipment are age appropriate and the surface area has resilient materials for safety. There are no bodies of water or hazards observed. Drinking water were observed to be available to children. *Continued on next page.*

SUPERVISOR'S NAME: Joel Segura	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: James G Santos	TELEPHONE: (408) 334-8556
LICENSING EVALUATOR SIGNATURE:	DATE: 05/27/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/27/2022

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: SPRINGBRIDGE INTERNATIONAL SCHOOL, LLC	FACILITY NUMBER: 434415740
	VISIT DATE: 05/27/2022

NARRATIVE

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CONTINUATION OF PREVIOUS PAGE (PAGE #1 - REPORT DATED 05/27/2022)

LPA reviewed ten (10) children's files. Children's records reviewed include Admission Agreement, Identification and Emergency Contact, Consent for Emergency Medical Treatment form, receipt of Parent Rights Notice, Personal Rights Notice, Physician's Report and Immunization Record.

LPA reviewed 7 staff files. Staff records reviewed include Criminal Record Clearance, Immunization Record, CPR/First Aid, Mandated Reported Training, Qualifications and Education. Per review of record, the center conducts emergency disaster drills monthly.

Tomoko Regan was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA advised Director to visit the Department’s website at www.cdss.ca.gov to access resources for Providers, Regulations, Online option to pay Annual License fee, Adoption of new Laws, etc.

No deficiencies cited. Exit interview conducted and report was reviewed with Licensee/Staff, Tomoko Regan and a copy was provided.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISOR'S NAME: Joel Segura	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: James G Santos	TELEPHONE: (408) 334-8556
LICENSING EVALUATOR SIGNATURE:	DATE: 05/27/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/27/2022

LIC809 (FAS) - (06/04)

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