434415223-9-15-2023-07-CC-MSMS-CVPP9W-20230915110748

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434415223
Report Date: 09/15/2023
Date Signed: 09/15/2023 11:07:52 AM

Document Has Been Signed on 09/15/2023 11:07 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:	CALIFORNIA YOUNG WORLD AT ELLIS		FACILITY NUMBER:	434415223
ADMINISTRATOR:	NORA LACAYO		FACILITY TYPE:	850
ADDRESS:	550 EAST OLIVE AVENUE		TELEPHONE:	(408) 774-0405
CITY:	SUNNYVALE	STATE: CA	ZIP CODE:	94086
CAPACITY: 24	TOTAL ENROLLED CHILDREN: 3	CENSUS: 3	DATE:	09/15/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Nora Lacayo		TIME COMPLETED:	11:30 AM

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), Mel Matos, met with Nora Lacayo, director, for an unannounced Required - 1 year inspection. LPA notes that the Facility is located on the campus of Ellis Elementary School in Rooms D101 (D1) & D102 (D2). Hours of operation: 8:30 AM to 11:30 AM Monday to Friday during the calendar school year for the Sunnyvale School District. The preschool program is closed during scheduled school breaks. LPA notes that the Facility also has a school age program (#430710561) which uses the same space; however, the school age program is only in operation from 6:30 AM to 8:30 AM and 12:45 PM to 5:45 PM Monday to Friday during the calendar school year. The school age program is open from 6:30 AM to 5:45 PM during school breaks. The preschool and school age programs have exclusive use of Rooms D101 (D1) & D102 (D2) when either program is in session. 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. LPA reviewed three children's (due to low enrollment) and three staff (1 director and 2 teachers) files during today's inspection. Each child's file reviewed contains the Information and Emergency Information form (LIC 700). All staff files reviewed contain the required transcripts/verification of experience/immunization records, and Health Screening Report. All staff have current certificates of completion of the Mandated Reporter Training for Child Care Workers on file. There is at least one staff in the Facility with current CPR and First Aid certifications on file. Nora understands that there shall be at least one person, with valid CPR and First Aid certifications, on site at all times or present during off-site activities (field trips). Last fire/disaster drill was completed on September 11, 2023. LPA observed that the teacher/child ratio was in compliance during today's inspection. LPA notes that the Facility is Title 5 funded and thus Title 5 ratios apply. LPA observed three preschool children with one teacher in Room D102 (D2). There were no preschool children in Room D101 (D1) during today's inspection. Nora understands the conditions, limitations, and capacity specifications of the Facility license. Nora understands that children shall be visually supervised at all times within the classroom and in the playground areas. Any child(ren) who exhibit symptoms of illness including, but not limited to, fever or vomiting, are not accepted in care. Any child(ren) who become ill during the day, shall be isolated in the director's office area in Room D101 (D1).

SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Melvin S Matos
LICENSING EVALUATOR SIGNATURE:	DATE: 09/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2023

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: CALIFORNIA YOUNG WORLD AT ELLIS	FACILITY NUMBER: 434415223
	VISIT DATE: 09/15/2023

NARRATIVE

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LPA observed that the Facility is clean, safe, sanitary, and in good repair for children, staff, and visitors. The Facility has central heating and air conditioning in both Rooms. Nora states that the Facility has a third-party cleaning service that cleans the Facility Monday through Friday in the evenings. Drinking water is readily available for the children in each Room and in the outdoor playground area via reusable water bottles and water dispensers.

Staff and children's bathrooms are clean, sanitary, and operable. There is a separate staff bathroom in Room D101 (D1)not utilized by the children which an isolated child can use if needed. Nora states that there are no weapons or firearms on the premises. The Facility has functioning carbon monoxide detectors in each Room. Cleaning supplies are inaccessible to the children and stored in high cabinets inside each classroom. LPA observed solid waste containers with tight-fitting lids in each Room. Nora states that the Facility does not administer any medication at this time. Nora understands that smoking is not allowed on the premises.

The Facility uses reusable plates & utensils to serve AM and PM snacks. There is a kitchen area in Room D101 (D1) with hot/cold water sink, toaster oven, microwave, and toaster for food preparation. The food preparation and storage areas are clean, free of litter & rubbish, and free of rodents and other vermin. All food and beverages that require refrigeration are stored in covered containers at 45 degrees F or less.

LPA observed all furniture and equipment is in good condition and safe for the children. The playground area utilized by preschool children is surrounded by appropriate fencing. The outdoor surfaces are safe for the children. Shade is provided by umbrellas, trees, and building overhangs in the playground area. LPA observed that the outdoor equipment is age appropriate and in good condition. There are no climbing structures in the playground. LPA did not observe any bodies of water. The preschool program has exclusive use of the playground areas whenever the preschool children are outdoors.

Nora Lacayo, director, was reminded 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. All criminal record background checks are associated to the preschool license (#430703885).
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 interview conducted and report was reviewed with Nora Lacayo, director, and advised her that no deficiencies issued during today's inspection. A notice of site visit was given and must remain posted for 30 days.

SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Melvin S Matos
LICENSING EVALUATOR SIGNATURE:	DATE: 09/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2023

LIC809 (FAS) - (06/04)

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