434415768-1-10-2020-07-CC-SYIP-BKPTGM-20200110134321

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434415768
Report Date: 01/10/2020
Date Signed: 01/10/2020 01:43:26 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:	CHILDREN'S COURTYARD, THE		FACILITY NUMBER:	434415768
ADMINISTRATOR:	SHAYLYNN LUCAS		FACILITY TYPE:	840
ADDRESS:	610 E DUNNE AVENUE		TELEPHONE:	(408) 778-1977
CITY:	MORGAN HILL	STATE: CA	ZIP CODE:	95037
CAPACITY:	50	CENSUS: 0	DATE:	01/10/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	10:36 AM
MET WITH:	Brandi Santos and Shaylnn Lucas		TIME COMPLETED:	12:32 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) Samantha Yip conducted an unannounced annual random inspection. LPA met with Brandi Santos and explained the reason for the inspection. There were no school-age children present during today's inspection. License and Emergency Disaster Plan was observed to be posted. Facility uses electronic sign in/sign out. LPA toured in the inside and outside of the facility. Disinfectant, cleaning supplies, and other items that are dangerous to children were observed to stored inaccessible to children. Furniture and equipment, such as tables and chairs, were observed to be in good condition and age appropriate. LPA observed that there is sufficient amount of toys for children in care. Restroom for children's use were in functioning condition and clean. Storage containers for waste have tight fitted lids. LPA observed a fully charged fire extinguisher, smoke detector, and carbon monoxide detector. The outdoor activity area is fenced. Shaded rest area is provided through canopy. There were no bodies of water observed during today's inspection. Facility does provide snacks to the children in care. Kitchen used to prepare snacks was observed to be clean. Drinking water is provided through water fountains and Brita and cups. ----------------------continues on 809 dated 01/10/2020 page 2-----------------------------------

SUPERVISOR'S NAME: Anthony Studebaker	TELEPHONE: (408) 324-2148
LICENSING EVALUATOR NAME: Samantha Yip	TELEPHONE: (408) 529-8128
LICENSING EVALUATOR SIGNATURE:	DATE: 01/10/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/10/2020

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: CHILDREN'S COURTYARD, THE	FACILITY NUMBER: 434415768
	VISIT DATE: 01/10/2020

NARRATIVE

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------------------------continuation of 809 dated 01/10/2020 page 1-----------------------------------

10 children's files were reviewed during today's inspection. The records reviewed include but not limited to admission agreement and consent for emergency medical treatment. LPA reminded Director to check the facility names written on forms.

15 staff files were reviewed during today's inspection. The records reviewed include but not limited to education credit and Mandated Reporter Training. There is currently at least one staff on site with a valid CPR/1st Aid, which expires on 03/09/2020.

There were no staff present during today's inspection.

Director stated that she currently does have children in care who requires Incidental Medical Services (IMS). Plan for Providing IMS is on file. Medication is properly stored where it is out of reach of children and with proper documentation. LPA reminded Director to check expiration date on medications.

In the areas evaluated during today's inspection, no deficiencies have been cited. An exit interview was conducted where this report was discussed and provided to Director Shaylnn Lucas. A notice of site visit has been issued and must be posted for 30 consecutive days.

SUPERVISOR'S NAME: Anthony Studebaker	TELEPHONE: (408) 324-2148
LICENSING EVALUATOR NAME: Samantha Yip	TELEPHONE: (408) 529-8128
LICENSING EVALUATOR SIGNATURE:	DATE: 01/10/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/10/2020

LIC809 (FAS) - (06/04)

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