434416277-2-26-2021-07-CC-DMAC-BYLPZ4-20210226104453

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434416277
Report Date: 01/15/2021
Date Signed: 02/26/2021 10:45:18 AM

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:	TULIP KIDS		FACILITY NUMBER:	434416277
ADMINISTRATOR:	NIKKI HUFANA		FACILITY TYPE:	830
ADDRESS:	10181 FINCH AVENUE		TELEPHONE:	(669) 377-5774
CITY:	CUPERTINO	STATE: CA	ZIP CODE:	95014
CAPACITY:	24	CENSUS: 0	DATE:	01/15/2021
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	01:10 PM
MET WITH:	Nikki Hufana, Site Director		TIME COMPLETED:	02:30 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 Analysts (LPAs) Dung Mac and Marilou Monico conducted a scheduled Tele Pre-Licensing inspection via video conference call (FaceTime) with Nikki Hufana, Site Director. The Applicant had submitted an application to license an Infant Program. There is an existing licensed Preschool program (#434416387) operated at the same site. A Fire Clearance was approved by Santa Clara County Fire Department on 12/9/2020. The Infant program will operate Monday through Friday from 08:00AM to 06:00PM, serving children ages 12 months -24 months. The Infant program will be using Room 4 (Preschool program are utilizing rooms 11-14 and Heritage program is in rooms 6 & 7). The facility was inspected inside and outside via video conference call (FaceTime). During today’s video conference call, the indoor/outdoor measurements were taken by Site Director, Nikki Hufana, as LPAs observed the measuring process and provided direction over the video conference call. ROOM 4: (27.416 x 24.250) - (6.000 x 1.000 + 12.916 x 8.083 + 3.833 x 1.75 encumbered space) = 664.838 - 117.107 = 547.731 *TOTAL INDOOR SPACE: 547.731 sq. ft. divided by 35 = 15 infants* Nikki states that Infant program will offer potty training. There is one sink available for the children (15) and there is potty chair (10 potty training children). Sink has cold water only. LPAs observed a changing table within arms reach of the sink. LPAs observed a trash can with a tight fitting lid for diapers disposal and a container with tight-fitting lid for disposal of solid waste. There are one table, 12 chairs, 12 mats, and 20 cubbies. Report continued on Page #2

SUPERVISOR'S NAME: Diana Stephenson	TELEPHONE: (408) 324-2158
LICENSING EVALUATOR NAME: Dung Mac	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR SIGNATURE:	DATE: 01/15/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2021

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: TULIP KIDS	FACILITY NUMBER: 434416277
	VISIT DATE: 01/15/2021

NARRATIVE

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There are separate staff bathrooms. Children who become ill will be isolated in Director's office with isolation equipment. Classroom is furnished with age appropriate toys. First aid supplies, medication, and cleaning supplies are stored inaccessible to children. Children will bring their own snacks and lunch. LPAs observed functioning smoke/carbon monoxide detectors in classroom. Drinking water is available indoors/outdoors via bottles. No transportation is provided.

Deepti Mohta, Applicant Representative, and Nikki Hufana, Site Director, have obtained a Criminal Records Clearance and Child Abuse Index Checks. Director has met the education and experience qualification requirement and has completed 17 hours of training on preventive health practices, which included pediatric cardiopulmonary resuscitation and pediatric first aid, one hour on Child Care Nutrition, and one hour on Lead Poisoning Prevention. The Director's Pediatric First Aid/CPR Certification expires 12/11/2022. The Director’s copies of immunization records and Health Screening with Tuberculosis clearance on file. The Director's Mandated Reporter Training for Child Care Provider Certification expires 6/28/2021.

LPAs reminded Nikki of the applicable civil penalties for those adults who have not received fingerprint clearances, are not associated to the facility, and who come in contact with or provide care and supervision to the children. For an initial violation, civil penalty amounts to $100.00 per person per day up to $500.00 per person. For a subsequent violation within a 12-month period, civil penalty amounts to $100.00 per person up to $3000.00 per person.

Infant yard is located inside Preschool yard. LPAs observed infant yard is surrounded and separated from preschool yard by at least 4' high fence. Shade is provided by canopies. Tanbark is utilized for resilient material around and under the play structure in the Infant playground. LPAs observed the outdoor activity space is equipped with a variety of age-appropriate toys and equipment. LPAs observed no bodies of water.

Report continued on Page #3

SUPERVISOR'S NAME: Diana Stephenson	TELEPHONE: (408) 324-2158
LICENSING EVALUATOR NAME: Dung Mac	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR SIGNATURE:	DATE: 01/15/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2021

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: TULIP KIDS	FACILITY NUMBER: 434416277
	VISIT DATE: 01/15/2021

NARRATIVE

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OUTDOOR MEASURES:

21.250 x 28.583 = 607.388

OUTDOOR SPACE TOTAL = 607.388 divided by 75 sq. ft. = 8 children

Infant playground has space for 8 Infants. There is not enough space for the requested Infant capacity of 12. As a result, a waiver for playground space will be requested by the Applicant.

The facility plans to provide Incidental Medical Services – IMS. IMS has been submitted to the Department. Information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

LPAs advised Nikki that due to the current Covid-19 pandemic and "Shelter In Place" Order, the Evaluation Report will be emailed to her (email:nhufana@tulipkidsinc.com) with "Read Receipt" notification. Nikki understands that her reply to the email will serve as acknowledgement that the report was received.

LPAs conducted an exit interview and advised Nikki that a license for 12 Infant children will be submitted for the final stage of review by Licensing Management upon the receipt of a waiver request along with staggered schedules for the playground space.

SUPERVISOR'S NAME: Diana Stephenson	TELEPHONE: (408) 324-2158
LICENSING EVALUATOR NAME: Dung Mac	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR SIGNATURE:	DATE: 01/15/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2021

LIC809 (FAS) - (06/04)

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