435700706-5-25-2021-52-CC-MOTI-C3CQTH-20210525122710

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 435700706
Report Date: 04/08/2021
Date Signed: 05/25/2021 12:27:53 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME:	CUSD MONTCLAIRE CUPERDOODLE PRESCHOOL		FACILITY NUMBER:	435700706
ADMINISTRATOR:	ALICE CHAN		FACILITY TYPE:	850
ADDRESS:	1160 ST. JOSEPH AVENUE		TELEPHONE:	(408) 252-3000
CITY:	LOS ALTOS	STATE: CA	ZIP CODE:	94024
CAPACITY:	24	CENSUS: 0	DATE:	04/08/2021
TYPE OF VISIT:	Case Management - Licensee Initiated	ANNOUNCED	TIME BEGAN:	01:41 PM
MET WITH:	Michelle Herriage		TIME COMPLETED:	02:01 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	THIS VISIT WAS CONDUCTED VIRTUALLY VIA THE ZOOM PLATFORM DUE TO COVID-19 PANDEMIC. A Case Management Visit was conducted on this date 04/08/2021 by Licensing Program Analyst (LPA), Melanie Otsuji. LPA met with Applicant, Michelle Herriage. Facility submitted an Application to add ROOM 24** as licensed space. Hours of operation are from 7:30AM - 6:00PM, Monday through Friday. A virtual health and safety inspection was conducted inside and outside. The following are the measurements: INDOORS: 1902.19 square feet = 54 children OUTDOORS: 10685.25 square feet = 142 children The preschool rooms are equipped with varied age appropriate materials and equipment. There are 5 toilets and 6 sinks available for children. The main office in the nurses station and the staff toilet will serve as isolation areas for sick children. There is a prep area. There are 2 play yards (Kinder Play ground and Preschool Play ground). Kinder playground is fenced in all around. The climbing structure in the Kinder Playground is not preschool appropriate and will not have access to the structure. The blacktop is the only accessible area in the Kinder Playground for the preschoolers. The climbing structure on the Preschool Playground is sufficiently cushioned with tanbark. Trees, building overhang and a canopy provide sufficient shade in both play yards. The center has functioning drinking fountains inside, jugs and cups, as well as water bottles for indoor and outdoor activities. The center will provide snacks. No cleaning agents were found stored with food. First aid supplies are available in the center. There is a working telephone on site. Carbon monoxide is available. The sign in/out sheets provide for a full signature.

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Melanie Otsuji	TELEPHONE: (510) 622-2613
LICENSING EVALUATOR SIGNATURE:	DATE: 04/08/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/08/2021

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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: CUSD MONTCLAIRE CUPERDOODLE PRESCHOOL	FACILITY NUMBER: 435700706
	VISIT DATE: 04/08/2021

NARRATIVE

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This facility plans to provide Incidental Medical Services – IMS. For IMS information, see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. A Plan of Operation that includes IMS must be submitted to the Department. The following 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.

Mandated reporter and appeal rights, civil penalties, unusual incident reporting and fingerprint requirements were discussed today. Licensee is also being informed of the web address (www.ccld.ca.gov) for downloading child care forms, and the director is encouraged to email ChildCareAdvocatesprogram@dss.ca.gov to be included in the Child Care Quarterly Updates distribution list The director is also reminded that mandated reporter training is required for all staff and is to be renewed every 2 years at www.mandatedreporterca.com.

Zero Tolerance policies were explained. The center was found to be clean, safe, sanitary, and in good repair.

There were no deficiencies cited today. Approval of Room 24 will be recommended as of today's date, 4/8/2021.

An exit interview was conducted.

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Melanie Otsuji	TELEPHONE: (510) 622-2613
LICENSING EVALUATOR SIGNATURE:	DATE: 04/08/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/08/2021

LIC809 (FAS) - (06/04)

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