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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434413199
Report Date: 02/16/2024
Date Signed: 02/16/2024 05:49:58 PM

Document Has Been Signed on 02/16/2024 05:49 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:LITTLE TREE MONTESSORI INTERNATIONAL SCHOOLFACILITY NUMBER:
434413199
ADMINISTRATOR:JAC QUELINE LUCILLE FUNKFACILITY TYPE:
850
ADDRESS:430 DARRYL DRIVETELEPHONE:
(408) 996-2708
CITY:CAMPBELLSTATE: CAZIP CODE:
95008
CAPACITY: 168TOTAL ENROLLED CHILDREN: 168CENSUS: 74DATE:
02/16/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Hui RenTIME COMPLETED:
12:30 PM
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Licensing Program Analysts (LPAs), Sheena Chin, conducted an unannounced Required - 3 year inspection of the Preschool. LPA met with the director, Hui Ren, and explained the purpose of the visit. The Facility is licensed to serve age 2 years old to entry into first grade. The Preschool holds a waiver to share the outdoor playground between age groups between 2 to 5 years old. Hours of operation: 8:00 AM to 6:00 PM Monday to Friday. The director stated that the facility does not have weapons on the premises, that smoking is not allowed on the premises and that the facility does not provide medicine intake services. The director stated that parents had to come to the school to give pills or tablets to their child. However, the director stated that the facility provided IP pen or inhaler services. The director stated that the facility provided 2 snacks and lunch for children in care. The preschool prepared snacks and the central kitchen in Los Gatos delivered lunches to the facility every school day. The property has 10 classrooms and one multipurpose room. Room 1, 2, 3, 4, 5, 6, 7 were for preschool use. Room 8, 9, 10 were used for heritage education.

Observation
LPAs toured the indoor and outdoor areas of the Facility with the director, Hui Ren.
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 were observed.

The facility has fully charged Fire Extinguishers, functioning smoke/carbon monoxide detectors. Fire Marshall came for fire inspection on 12/29/2023. First Aid Kit, central heating, and air conditioning were observed in all rooms. Furniture and equipment were observed to be age appropriate and in good condition, free of sharp, loose, or pointed parts. Disinfectants, cleaning solutions, poisons, sharps, and other items that are dangerous to children were stored inaccessible. Restrooms for children to use were observed to be in operating condition. Play equipment were maintained in a good condition, free of hazards.

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SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Sheena Chin
LICENSING EVALUATOR SIGNATURE: DATE: 02/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/16/2024
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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: LITTLE TREE MONTESSORI INTERNATIONAL SCHOOL
FACILITY NUMBER: 434413199
VISIT DATE: 02/16/2024
NARRATIVE
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Observation
The facility provides lunch and 2 snacks. Lunches are prepared and packaged by the Central Kitchen at Los Gatos, and then delivered to the facility. The food storage areas were clean, free of litter, rubbish, and rodents/vermin. Foods and beverages were kept protected against contamination and spoilage. All food and beverages that require refrigeration are stored in covered containers at 45 degrees F or less. Trash cans for solid waste had tight-fitting covers on.

The teacher/child ratio was in compliance during today's inspection. There’re two qualified teacher in each classroom, where had less than 15 children. The director stated that she understands the conditions, limitations, and capacity specifications of the Facility license and that children shall be always supervised within the classroom and in the playground areas.

The playground area is surrounded by appropriate fencing. Shade is provided by trees on the street in the playground area. The outdoor equipment is age-appropriate and in good condition. There is a climbing structure in the playground that is age appropriate. Rubber surfacing is used as resilient material throughout the playground. However, small holes were observed throughout the rubber surface. The director stated that children liked to pick and poke the rubber surface. The director stated that no contractors were willing to repair the rubber surface but to replace. Areas around and under high climbing equipment were cushioned with material that absorbs falls. There were no bodies of water observed.

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SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Sheena Chin
LICENSING EVALUATOR SIGNATURE:

DATE: 02/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/16/2024
LIC809 (FAS) - (06/04)
Page: 2 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: LITTLE TREE MONTESSORI INTERNATIONAL SCHOOL
FACILITY NUMBER: 434413199
VISIT DATE: 02/16/2024
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Records review
Disaster drills shall be conducted at least every six months and be maintained for at least one year. The last drills were conducted on 12 / 11 / 23 .
LPA reviewed facility's sign in/out procedure and record. A sampling of children and staff files was selected for review. Children records reviewed includes Admission Agreement, Identification and Emergency Information, Consent for Emergency Medical Treatment form, Medical Assessment, and immunization. Staff records reviewed include Criminal Record and Child Abuse Index Background Check Clearance, Health Screening Report with TB Clearance, Immunization Record for Measles and Pertussis, Education Qualification, and required Training. LPA advised the director that the AB1207 Mandated Reporter Training needs to be renewed every two years. There was at least one person with documented current certification in Pediatric CPR/1st Aid present at the facility during LPA' inspection.

LPA advised the director that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Discussion
Water lead test: Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1- CCP). LPA verified that the lead testing was completed on 12/28/2022 in accordance to the Written Directives outlined in PIN 21-21.1.CCP. LPA referred the director to the Department website for lead: Lead Toxicity Prevention and Water Testing Information. Beginning January 1, 2019 AB2370 requires licensed homes and centers to share information on the risks and effects of lead exposure with enrolling and re-enrolling families.

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SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Sheena Chin
LICENSING EVALUATOR SIGNATURE:

DATE: 02/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/16/2024
LIC809 (FAS) - (06/04)
Page: 3 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: LITTLE TREE MONTESSORI INTERNATIONAL SCHOOL
FACILITY NUMBER: 434413199
VISIT DATE: 02/16/2024
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Incidental Medical Services (IMS): This facility only provides IP pen or inhaler medical services to children in care. 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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. When any IMS is provided, an updated 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) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

Deficiency
In the areas that were evaluated, no regulatory violations were observed at the time of the inspection.
There were no deficiencies cited at this time.

Further questions
To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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.

Exit
Notice of Site Visit was given and must remain posted for 30 days.
Exit interview conducted and report was reviewed with the director, Hui Ren .
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Sheena Chin
LICENSING EVALUATOR SIGNATURE:

DATE: 02/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/16/2024
LIC809 (FAS) - (06/04)
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