434415958-1-27-2021-07-CC-JTSE-BXNV2Q-20210127150332

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434415958
Report Date: 01/27/2021
Date Signed: 01/27/2021 03:03:42 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:	SORA INTERNATIONAL PRESCHOOL OF CAMPBELL		FACILITY NUMBER:	434415958
ADMINISTRATOR:	SARMA, MANJUSREE		FACILITY TYPE:	850
ADDRESS:	771 WALDO ROAD		TELEPHONE:	(408) 628-4455
CITY:	CAMPBELL	STATE: CA	ZIP CODE:	95008
CAPACITY:	26	CENSUS: 0	DATE:	01/27/2021
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Reiko Nakauchi		TIME COMPLETED:	02:00 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	LPA Janet Tse met with applicant Reiko Nakauchi to conduct a change of location pre-licensing inspection. The inspection was conducted via Facetime due to the COVID-19 pandemic. Present were also applicant's husband Taka Nakauchi and administrator Nana Spade. The preschool was previously located at 701 East Meadow Drive, Palo Alto, CA 94303 with license #434412409. LPA toured the facility as well as measured the indoor and outdoor space with the assistance of Taka Nakauchi. The preschool only has one classroom. The following indoor measurements were taken today: CLASSROOM 39.083 x 24.333 minus 41.039 (encumbered space) = 910.027 *TOTAL PRESCHOOL INDOOR SPACE: 910.027 sq. ft. divided by 35 = 26 children* It is noted that the cots will be stored in the Workroom/Storage which is off limits to the day care children. The cots were not included in the calculated encumbered space. There are 2 toilets (30) and 3 sinks (45) available for the children. Only cold water is available in the children's sinks. There is 1 separate staff bathroom which is located next to the children's bathroom, and it will be used by the sick child. The sick child will be isolated in the Director's office and isolation equipment is provided. LPA observed no fireplaces or wall heaters at the facility. Central air conditioning/heating is provided in the building. The rooms have appropriate lighting. The center will be administering medication. Medication lock box and first aid supplies are located in the upper cabinet in the children's bathroom inaccessible to children. Cleaning supplies are stored in the kitchen. The center will be providing snacks for the children and snacks will be prepared in the kitchen. Children will bring their own lunch. Applicant stated meals might be provided by a third party vendor in the future. The kitchen is equipped with refrigerator, microwave, stove, oven, dishwasher, and sink with hot and cold running water. Regular and disposable dishes and cups will be utilized for the children. Regular dishes and cups will be sanitized thru the dishwasher. LPAs observed solid waste container with tight-fitting lid in the Facility Evaluation Report dated 01/27/2021 to be continued on next page: - Page 1 of 3 -

SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Janet Tse	TELEPHONE: (408) 334-8547
LICENSING EVALUATOR SIGNATURE:	DATE: 01/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2021

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: SORA INTERNATIONAL PRESCHOOL OF CAMPBELL	FACILITY NUMBER: 434415958
	VISIT DATE: 01/27/2021

NARRATIVE

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Facility Evaluation Report dated 01/27/2021 to be continued from previous page:
kitchen. There are 30 cubbies, 5 tables of different sizes, 25 chairs, and 30 cots. Some children will be coming to the center on a part-time basis. Children will bring their own water bottles, and drinking water is also available indoor by filtered water faucet and drinking fountains.

Outdoor measurements and information are:
PRESCHOOL PLAYGROUND
1/2 x 20.917 x 90 = 941.265
41.500 x 90 = 3735
Playground total = 941.265 + 3735 = 4676.265
TOTAL PRESCHOOL OUTDOOR SPACE: 4676.265 sq. ft. divided by 75 = 62 children.

The playground is surrounded by appropriate fencing. LPA observed an outdoor space connected to the playground in the back separated by a fence which is not included in the fire clearance. Applicant understands that the outdoor space not included in the fire clearance cannot be used by the day care children. LPA observed no outdoor equipment or toys in the playground. Applicant stated there are bicycles, play equipment, and playhouses in storage. LPA advised Applicant to send a picture of the playground with play equipment to LPA for approval. The playground is covered with tan barks and sand as resilient material. Drinking water is provided thru a water fountain and children will also bring their water bottles. LPA observed no bodies of water. No transportation is provided by the school. Shade is provided thru large trees and building overhang.

LPA observed there is no records to indicate that any facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. LPA advised Applicant to transfer the staff's fingerprint clearances through Guardian. LPA reminded Applicant of the applicable civil penalties for those adults who have not received fingerprint clearances, are not associated to the license and who come in contact with or provide care and supervision to the children. Penalty amounts: $100.00 per person per day, minimum of $100.00 to a maximum of $500.00 per person for an initial violation and a minimum of $100.00 to a maximum of $3000.00 per person for any subsequent violations within a 12 month period.

Applicant stated the site director of this facility will be Flordliza Berenstein. The Site Director's certification of lead information training with date of completion is needed. Site Director's
Facility Evaluation Report dated 01/27/2021 to be continued on next page: - Page 2 of 3 -

SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Janet Tse	TELEPHONE: (408) 334-8547
LICENSING EVALUATOR SIGNATURE:	DATE: 01/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2021

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: SORA INTERNATIONAL PRESCHOOL OF CAMPBELL	FACILITY NUMBER: 434415958
	VISIT DATE: 01/27/2021

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Facility Evaluation Report dated 01/27/2021 to be continued from previous page:
qualification will be reviewed and verified. A fire clearance for 26 children was received from the Santa Clara County Fire Department prior to today's visit.

An exit interview was conducted prior to the conclusion of today's inspection and LPA advised Applicant that a license for 26 children is pending on the compliance of Licensing requirements and Licensing Management approval.

A packet of current mandatory directives regarding COVID-19 from the Santa Clara County Health Department, and a Child Care Program COVID-19 Self Assessment will be emailed to Applicant.

Due to COVID 19, a copy of this Licensing report with LPA's signature alone will be emailed to Applicant; and in lieu of Applicant's signature, a read receipt of the email will serve as acknowledgement of receipt of this Licensing report by Applicant.
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SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Janet Tse	TELEPHONE: (408) 334-8547
LICENSING EVALUATOR SIGNATURE:	DATE: 01/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2021

LIC809 (FAS) - (06/04)

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