434416196-3-25-2024-07-CC-MKAR-D3PV4F-20240325160616

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434416196
Report Date: 03/25/2024
Date Signed: 03/25/2024 04:06:23 PM

Document Has Been Signed on 03/25/2024 04:06 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:	COMMUNITY FIRST SCHOOL		FACILITY NUMBER:	434416196
ADMINISTRATOR:	LE, DIEU-MI		FACILITY TYPE:	850
ADDRESS:	1098 WEST REMINGTON DRIVE		TELEPHONE:	(408) 739-2022
CITY:	SUNNYVALE	STATE: CA	ZIP CODE:	94087
CAPACITY: 144	TOTAL ENROLLED CHILDREN: 127	CENSUS: 48	DATE:	03/25/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	12:30 PM
MET WITH:	Dieu-Mi Le		TIME COMPLETED:	04:20 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 Analysts (LPAs) Marilou Monico and Mandeep Kaur met with Site Director, Dieu-Mi Le, for an unannounced Annual/Random Inspection. The purpose of today's inspection was explained with Site Director. Facility's License, Notification of Parents’ Right Poster, Child Car Seat Law, Personal Rights (LIC 613A), Emergency Disaster Plan, Menus, Activity Schedule, and Earthquake Preparedness Checklist were observed to be posted. The center's operating hours are Monday through Friday from 07:00 AM to 6:00 PM. The facility is licensed to serve children ages 2 years to entry into Kindergarten in Rooms #2,#3,#6,#7,#8, and #9. LPAs toured the indoor and outdoor areas. Fire drill was conducted on December 14, 2023. The facility has current children's roster and a copy was provided to LPAs during the inspection. Cleaning products, disinfectants, sharp objects were stored inaccessible to children. Furniture and equipment were observed to be age appropriate and in good condition. The facility is clean. The bathrooms for children and staff are clean, sanitary, and operable. LPAs observed 12 toilets and 16 sinks available for the children. Site Director stated that the center has a third party cleaning service that comes and clean the facility after daycare hours. The center provides morning snacks, lunch, and afternoon snacks to the children. There is a kitchen at the facility for food preparation. The kitchen is equipped with refrigerators, stove, oven, microwave, 2 dishwashers, storage space for food, and a sink with hot and cold running water. Drinking water is available for the children indoor using fountain water and individual water bottles. LPAs observed trash cans with tight fitting covers for the disposable of solid waste. The facility has fire extinguishers and working smoke and carbon monoxide detectors. LPAs observed that the adequate room temperature in all of the rooms. The playgrounds are surrounded with appropriate fencing and the outdoor surfaces are safe. Shade is provided by trees and canopies. LPAs observed climbing structures with resilient material (rubber foam & tanbarks) under and around the structures. There were no bodies of water observed. Site Director stated that there are no weapons or firearms on the premises. Continuation on next pages:

SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Mandeep Kaur
LICENSING EVALUATOR SIGNATURE:	DATE: 03/25/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/25/2024

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: COMMUNITY FIRST SCHOOL	FACILITY NUMBER: 434416196
	VISIT DATE: 03/25/2024

NARRATIVE

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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).

LPAs verified that the lead testing was completed in accordance to the Written Directives
outlined in PIN 21-21.1-CCP.

Site Director, Dieu-Mi Le 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&R's) 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/process.

As a result of this inspection, Type B deficiencies were cited on the following page:

Exit interview conducted and report was reviewed with Site Director, Dieu-Mi Le.

A NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 DAYS.

SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Mandeep Kaur
LICENSING EVALUATOR SIGNATURE:	DATE: 03/25/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/25/2024

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: COMMUNITY FIRST SCHOOL	FACILITY NUMBER: 434416196
	VISIT DATE: 03/25/2024

NARRATIVE

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LPAs reviewed 6 random children's files. Children records reviewed include Admission Agreement,
Identification and Emergency Information, Consent for Emergency Medical Treatment, Physician's Report, TB test, Immunizations, Parent Right's Receipt, Personal Rights, and Health History.

LPAs reviewed 15 staff files. Staff records reviewed include Employee Rights, Statement Acknowledging
Requirement to Report Child Abuse, Health Screening Report with TB Clearance, Immunizations (Measles,
Pertussis, and Influenza) and required training. Based on records review, 1 out of 15 of the staff (S4) has expired Mandated Reporter Training. LPAs reminded Site Director that the Mandated Reporter Training shall be renewed by all staff every two years. LPAs completed Evaluation of Teacher Qualification ( LIC 9095) for 6 of the staff. Based on the records review, 3 out of 15 of the staff (Staff #1, #2, and #5) need to complete required courses to be a fully Qualified Teacher at the center. Site Director was provided the required Teacher Qualifications per Title 22 Regulations. At least one staff member present during the inspection has current Pediatric CPR/First Aid certifications.

This facility provides Incidental Medical Services – IMS. LPAs 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/resources/child-care-centers/.

Site Director, Dieu-Mi Le, 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.

LPAs discussed the Healthy Beverages requirements in Child Care with Site Director.

Continuation on next page:

SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Mandeep Kaur
LICENSING EVALUATOR SIGNATURE:	DATE: 03/25/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/25/2024

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 03/25/2024 04:06 PM - It Cannot Be Edited

Created By: Mandeep Kaur On 03/25/2024 at 02:46 PM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: COMMUNITY FIRST SCHOOL	FACILITY NUMBER: 434416196
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/25/2024

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 1 out of 15 of the staff (Staff #4) which poses potential health, safety or personal rights risk to persons in care.
	POC Due Date: 04/12/2024
	Plan of Correction
1 2 3 4	By POC date: 04/12/24, the center will submit the certificate of completion of the Mandated Reporter Training (AB1207).

Type B

Section Cited

CCR

101216.1(c)(1)

Teacher Qualifications and Duties

(c) To be a fully qualified teacher, a teacher shall have one of the following: (1) Twelve postsecondary semester or equivalent quarter units in early childhood education or child development completed, with passing grades, at an accredited or approved college or university; and at least six months of work experience in a licensed child care center or comparable group child care program. 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 3 out of 15 of the staff (Staff #1, #2 and #5) which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 04/12/2024
	Plan of Correction
1 2 3 4	By POC date: 04/12/24, the center will submit the written plan of correction or proof of the enrollment of the courses for the teachers.

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:

Joel Segura

LICENSING EVALUATOR NAME:

Mandeep Kaur

LICENSING EVALUATOR SIGNATURE:

DATE: 03/25/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/25/2024

LIC809 (FAS) - (06/04)

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