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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434415122
Report Date: 11/05/2025
Date Signed: 11/05/2025 03:26:15 PM

Document Has Been Signed on 11/05/2025 03:26 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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:BUILDING KIDZ OF MOUNTAIN VIEWFACILITY NUMBER:
434415122
ADMINISTRATOR/
DIRECTOR:		EBUN EVIENFACILITY TYPE:
830
ADDRESS:250 EAST DANA STREETTELEPHONE:
(650) 967-8000
CITY:MOUNTAIN VIEWSTATE: CAZIP CODE:
94041
CAPACITY: 78TOTAL ENROLLED CHILDREN: 78CENSUS: 37DATE:
11/05/2025
TYPE OF VISIT:Annual/RequiredUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Site Director Ebun EvienTIME VISIT/
INSPECTION COMPLETED:
03:45 PM
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On 11/5/2025 at 9 am, Licensing Program Analyst Manel Estoesta conducted an Annual Required Visit. LPA met with the Director Ebun Evien & the Licensee Raji Sridhara and explained the nature of the visit. Present on the visit were 22 Staff Member and 71 Preschool Children, 12 toddlers and 25 infants. The facility is open from Monday to Friday, 7 am to 6 pm.

The licensee has a dual license, and the facility is a combination center. The Infant Program license number is 434415122 and another for Preschool Program license number is 434415123. The infant licensed rooms are rooms 5, 6 and 7, the toddler licensed room is room 8, and the preschool licensed rooms are 1 to 4. LPA toured the facility to conduct a Health and Safety Inspection with the Director.

Facility’s License, Parents’ Rights Poster, Personal Rights, Activity Schedules, Waiver, were observed to be posted. Children were engaged in various activities under the visual supervision of the teachers. The facility is within ratio and in capacity compliance today.

The classrooms, restrooms, kitchen/pantry, storage room, staff room and office area were inspected. Disinfectants, cleaning solutions, and other items that are dangerous to children were stored inaccessible to children. Cabinets, drawers, and rooms used for storage were locked. Furniture and equipment such as, but not limited to, changing tables, cribs, mats, cots, and feeding chairs, were age appropriate, and were in good condition, free of sharp, loose, or pointed parts. Restrooms for children's use were observed to be in safe, sanitary, and functioning condition. Floors were clean and free from tripping hazard.

NAME OF LICENSING PROGRAM MANAGER: Jason Jang
NAME OF LICENSING PROGRAM ANALYST: Manel Estoesta
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 11/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/05/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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: BUILDING KIDZ OF MOUNTAIN VIEW
FACILITY NUMBER: 434415122
VISIT DATE: 11/05/2025
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Outdoor activity spaces are physically separate from space used by children in other programs. Outdoor activity space is fenced and was inspected. The play equipment was maintained in a safe condition and free of hazards. There were no bodies of water observed. Areas around and under high climbing equipment and slides were cushioned with material that absorbs falls. There were shaded rest areas for children. Drinking water is arranged to be readily available to children during indoor and outdoor activities.

The food-preparation and storage areas were observed to be clean and free of litter and rubbish; and measures were taken to keep all such areas free of rodents and other vermin. All food was protected against contamination. Menu items were posted. Children’s lunch and snacks are provided by the facility. Trash cans for solid waste had tight-fitting covers on and were in good repair. Infant bottles were observed to be sterilized. Bottles, dishes and containers of food brought by the infant's authorized representative were labeled with the infant's name and the current date.

Facility files were reviewed. Children sign in logs for the day were reviewed and LPA obtained copies of the sign in sheet for the day. The facility is currently using a software application, for daily operations on recordkeeping. LPA observed Children’s attendance board in each classroom. LPA observed Smoke and Carbon Monoxide Detectors, fire pull stations, fire extinguishers and sprinkler system. The facility conducted Fire and Disaster Drills monthly, and the last drills were conducted on 10/15/2025. The facility does not provide transportation for children.

A sample of Children's files was taken for review. The records reviewed include Admission Agreement, Identification and Emergency Information, Medical Assessment, Sleep Logs, Infant /Toddler Needs and Services Plan, LIC 9227 Infant Sleeping Plan, Incident/accident/ouch report, PARENT CONSENT FOR ADMINISTRATION OF MEDICATIONS AND MEDICATION CHART, and NEBULIZER CARE CONSENT form, and Immunization.

The Director stated that the facility does handle medications and does currently have children in care who require Incidental Medical Services - IMS Epinephrine and Inhaled Medication. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information, see Evaluator Manual – Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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.

NAME OF LICENSING PROGRAM MANAGER: Jason Jang
NAME OF LICENSING PROGRAM ANALYST: Manel Estoesta
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 11/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/05/2025
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: BUILDING KIDZ OF MOUNTAIN VIEW
FACILITY NUMBER: 434415122
VISIT DATE: 11/05/2025
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A sample of Staff's files was taken for review. There was at least one Teacher with current certification in Pediatric CPR and First Aid present at the facility during inspection. LPA reminded the Facility Representative that Mandated Reporter Training for Child Care Providers training online at https://mandatedreporterca.com/ requires a 2-year requirement. LPA reviewed Staff Immunization records of Measles and Pertussis immunization, Influenza vaccination and TB clearance. LPA reminded Facility Representative that only the Influenza vaccination can be decline with a written declination.

The director was reminded that all adults 18 and over, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA discussed to the Director about the 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. The facility’s last Sample Date was on 05/03/2022.

The Director was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

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.

There are no deficiencies cited on this visit.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Director Ebun Evien and Licensee Raji Sridhara.

NAME OF LICENSING PROGRAM MANAGER: Jason Jang
NAME OF LICENSING PROGRAM ANALYST: Manel Estoesta
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 11/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/05/2025
LIC809 (FAS) - (06/04)
Page: 4 of 4