434400448-6-20-2022-07-CC-AMOS-CFKL93-20220620083248

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434400448
Report Date: 06/16/2022
Date Signed: 06/20/2022 08:33:17 AM

Document Has Been Signed on 06/20/2022 08:33 AM - 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:	MARTINSON CHILD DEVELOPMENT CENTER		FACILITY NUMBER:	434400448
ADMINISTRATOR:	LIMOS, ROSIE		FACILITY TYPE:	850
ADDRESS:	1350 HOPE DRIVE		TELEPHONE:	(408) 988-8296
CITY:	SANTA CLARA	STATE: CA	ZIP CODE:	95054
CAPACITY:	70	CENSUS: 30	DATE:	06/16/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Connie Mapanao		TIME COMPLETED:	02:25 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) conducted an ANNUAL REQUIRED INSPECTION and was greeted by Connie Mapanao, Assistant Director. Executive Director Rosie Limos was unavailable during the visit, however, LPA was able to speak to her by phone to inform her the purpose of this visit. The Centers hours of operation are Monday-Friday, 7:30am-6:00pm. 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), Menus, and Activity Schedule. Last disaster drill was conducted on 4/24/22 LPA observed a current Children's roster. The Facility has one active waiver on file (up to 12 school age children - in school age room) and is in compliance with the conditions of the waiver. There are four classrooms inside the center: 1. Classroom- Bumble Bees Room- Nine Preschool aged children, One qualified teacher and two aides. 2. After School Program- Seven children and one teacher 3. Room 3- Preschool- 11 preschool aged children, One qualified teacher and Two aides. 4. Toddler Room- five toddlers, Two Qualified teachers Facility was observed to be in compliance with teacher to child ratio requirement during visit. (1/3)

SUPERVISOR'S NAME: Diana Stephenson	TELEPHONE: (408) 324-2128
LICENSING EVALUATOR NAME: Anna Morales	TELEPHONE: (408) 334-8325
LICENSING EVALUATOR SIGNATURE:	DATE: 06/16/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2022

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: MARTINSON CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 434400448
	VISIT DATE: 06/16/2022

NARRATIVE

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Fully Charged, B402 Fire extinguishers were observed in the classrooms. The Carbon monoxide detectors are interconnected with the smoke alarms located on the ceilings. Disinfectants and toxics materials are stored inaccessible to the children. Observed trash bins with tight fitted lids. First aid kit was observed. Parent sign in and out is placed on a table close to the entrance of the building. The isolation room is in the main office. This facility is providing Incidental Medical Services – IMS Plan, however, none of the children currently enrolled are using medication.

LPA observed fully fenced playground area. Observed climbing structures and with materials that observe falls. Shade is provided by the patio cover. The children use there own water bottles, and the water is also provided by the school. Playground is age appropriate.

LPA reviewed a random selection of children files. Children records reviewed include , Identification and Emergency Contact, Medical Assessment and Immunization

LPA reviewed a random selection of (12)Staff records reviewed include Health Screening Report and TB test, and Immunization (Measles, Pertussis, and Flu) record and current Mandated Reporter Training. LPA reviewed that 10 out the 12 staff files have expired LPA reminded Director that the online AB1207 Mandated Reported Training needs to be renewed every two years. There was at least one person with current certification in Pediatric CPR and First Aid present at the facility.

LPA discussed the requirements of AB 633 with the Director. The Director understands the AB 633 fact sheet/copy of Acknowledgement of Receipt of Licensing Reports (LIC 9224). LPA discussed "zero tolerance" related regulations with the Director and advised the Director of the assessment of an immediate $500 per day civil penalty for any violation of a "zero tolerance" related regulation. An ongoing civil penalty of $100 per day continues until the violation(s) is corrected.

SUPERVISOR'S NAME: Diana Stephenson	TELEPHONE: (408) 324-2128
LICENSING EVALUATOR NAME: Anna Morales	TELEPHONE: (408) 334-8325
LICENSING EVALUATOR SIGNATURE:	DATE: 06/16/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2022

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: MARTINSON CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 434400448
	VISIT DATE: 06/16/2022

NARRATIVE

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Deficiencies are being cited based on the LPA's observations, interviews conducted and records reviewed in accordance with the California Code of Regulations Title 22. Exit interview was conducted with Assistant Director Connie Mapanao.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process

NOTICE OF SITE VISIT WAS ISSUED. LICENSEE WAS INFORMED TO POST THE NOTICE IN A VISIBLE LOCATION OF THE DAY CARE FOR A PERIOD OF 30 DAYS.

SUPERVISOR'S NAME: Diana Stephenson	TELEPHONE: (408) 324-2128
LICENSING EVALUATOR NAME: Anna Morales	TELEPHONE: (408) 334-8325
LICENSING EVALUATOR SIGNATURE:	DATE: 06/16/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2022

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 06/20/2022 08:33 AM - It Cannot Be Edited

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: MARTINSON CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 434400448
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/16/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in 10 out of 12 staff's Mandated Reporter Training expired in 2021(8 staff ) and 2022(two staff) which poses/posed a health, safety or personal rights risk to persons in care.
	POC Due Date: 07/18/2022
	Plan of Correction
1 2 3 4	Director stated that she will submitt current copies of the MANDATED REPORTER TRAINING to CCL by the POC Date, 7/18/2022

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Diana Stephenson	TELEPHONE: (408) 324-2128
LICENSING EVALUATOR NAME: Anna Morales	TELEPHONE: (408) 334-8325
LICENSING EVALUATOR SIGNATURE:	DATE: 06/16/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2022

LIC809 (FAS) - (06/04)

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