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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434415767
Report Date: 02/17/2022
Date Signed: 02/17/2022 04:40:10 PM

Document Has Been Signed on 02/17/2022 04:40 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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:CHILDREN'S COURTYARD, THEFACILITY NUMBER:
434415767
ADMINISTRATOR:SHAYLYNN LUCASFACILITY TYPE:
850
ADDRESS:610 E DUNNE AVENUETELEPHONE:
(408) 778-1977
CITY:MORGAN HILLSTATE: CAZIP CODE:
95037
CAPACITY: 96TOTAL ENROLLED CHILDREN: 96CENSUS: 53DATE:
02/17/2022
TYPE OF VISIT:Case Management - Legal/Non-complianceUNANNOUNCEDTIME BEGAN:
10:01 AM
MET WITH:Annabelle CalasanzTIME COMPLETED:
01:20 PM
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Licensing Program Analyst (LPA) Samantha Yip conducted an unannounced Case Management- Legal/Non-compliance inspection. LPA met with Director Annabelle Calasanz and explained the reason for the inspection. The purpose of this inspection is to ensure that facility is adhering to plan of correction implemented during the Non-Compliance Conference held on 04/29/2021 in regards to providing care and supervision and health-related services. Present during today's inspection were 53 children and at least 7 staff.

LPA toured the facility with Assistant Director Rocio Andrade. LPA observe in the 2 years old yard that there were some children under the play structure and by the door. There were two staff present at the time. Staff were attending to other children at the time. Children could be visually supervised. LPA reminded Director that children need to be visually supervised at all time and staff can visually supervise any blind spots. LPA also conducted interview with Director Annabelle Calasanz. She stated that Assistant Director Rocio and Program Director Brandi will go out the yards to remind staff to be always circling the yard. Director stated that Program Director Brandi and herself will do training with staff about safety and supervision.

LPA also discussed with Director about plans to ensure that any behavior intervention plan are being followed. Director also stated that they will be conducting a in-service training with staff on 02/21/2022 where they will do training on their My Path app, which is an app that staff can use as a resource for any behavior problem. Director stated that staff will be working with their behavior therapist.

-------------------------continues on 809 dated 02/17/2022 page 2---------------------------------
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Samantha Yip
LICENSING EVALUATOR SIGNATURE: DATE: 02/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/17/2022
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: CHILDREN'S COURTYARD, THE
FACILITY NUMBER: 434415767
VISIT DATE: 02/17/2022
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--------------------continuation of 809 dated 02/17/2022 page 1-----------------------------------

A copy of in-service training agenda was obtained during today's inspection.

As a result of this inspection, no deficiencies were cited. Exit interview conducted and report was reviewed with Director Annabelle Calasanz. A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall results in an immediate civil penalty of $100.
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Samantha Yip
LICENSING EVALUATOR SIGNATURE:

DATE: 02/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/17/2022
LIC809 (FAS) - (06/04)
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