434416282-3-29-2023-07-CC-MMOO-CQDVVW-20230329164658

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434416282
Report Date: 03/29/2023
Date Signed: 03/29/2023 04:47:12 PM

Document Has Been Signed on 03/29/2023 04:47 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:	DELIGHT MONTESSORI PRESCHOOL LLC		FACILITY NUMBER:	434416282
ADMINISTRATOR:	ARCHANA NAPHADE		FACILITY TYPE:	850
ADDRESS:	6191 BOLLINGER ROAD		TELEPHONE:	(408) 310-2709
CITY:	CUPERTINO	STATE: CA	ZIP CODE:	95014
CAPACITY:	24	CENSUS: 17	DATE:	03/29/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:40 PM
MET WITH:	Archana Naphade & Rashida Naqvi		TIME COMPLETED:	05:00 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 Analyst (LPA) Marilou Monico conducted an unannounced Required - 1 Year Inspection. LPA met with Site Director, Archana Naphade, and Site Director/teacher, Rashida Naqvi, and explained the purpose of today's visit. 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 08:00 AM to 6:00 PM. The center is utilizing three classrooms: Rooms 1 thru 3. The facility serves children ages 2 years old to entry into first grade. LPA toured the indoor and outdoor areas. LPA observed that the facility was operating in compliance with teacher to children ratio requirement. 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 staff and children's bathrooms are clean, sanitary, and operable. Archana stated that the facility has third party cleaning service that comes after daycare hours to clean the facility. The center provides morning and afternoon snacks to children. Parents provide lunch. Archana stated that only dry snacks are served to children. Foods and beverages were kept protected against contamination and spoilage. Drinking water is available for the children indoor via water bottles. LPA observed trash cans with tight fitting covers for the disposal of solid waste. LPA observed fire extinguishers, working smoke and carbon monoxide detectors. Continuation on next pages:

SUPERVISOR'S NAME: Joel Segura	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Marilou Monico	TELEPHONE: (408) 334-8549
LICENSING EVALUATOR SIGNATURE:	DATE: 03/29/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/29/2023

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: DELIGHT MONTESSORI PRESCHOOL LLC	FACILITY NUMBER: 434416282
	VISIT DATE: 03/29/2023

NARRATIVE

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Archana stated that there are no firearms in the facility. Drinking water is readily available for the children outdoor via individual water bottles. The playground is surrounded by appropriate fencing and the outdoor surfaces are safe. Shades are provided by trees and building overhang. LPA observed tanbarks as resilient material under and around the climbing structures. There were no bodies of water observed.

LPA reviewed six(6) children's files. Children records reviewed include Admission Agreement, Identification and Emergency Information, Consent for Emergency Medical Treatment form, Parent Right's Receipt, Personal Rights, Physician's Report, Health History, Immunization, and TB test.

LPAs reviewed four (4) 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. LPA reminded Archana that the Mandated Reported Training shall be renewed by all staff every two years. At least one staff member present during the inspection has current Pediatric CPR/First Aid certifications.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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)/ (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

Archana 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 observed that Staff #4 has been working without fingerprint clearances associated at this site. Staff #4 is associated to other Delight Montessori location.

Continuation on next page:

SUPERVISOR'S NAME: Joel Segura	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Marilou Monico	TELEPHONE: (408) 334-8549
LICENSING EVALUATOR SIGNATURE:	DATE: 03/29/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/29/2023

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: DELIGHT MONTESSORI PRESCHOOL LLC	FACILITY NUMBER: 434416282
	VISIT DATE: 03/29/2023

NARRATIVE

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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, deficiencies were cited on the following pages:

Exit interview conducted and report was reviewed with Site Director, Archana Naphade.

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

SUPERVISOR'S NAME: Joel Segura	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Marilou Monico	TELEPHONE: (408) 334-8549
LICENSING EVALUATOR SIGNATURE:	DATE: 03/29/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/29/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 03/29/2023 04:47 PM - It Cannot Be Edited

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: DELIGHT MONTESSORI PRESCHOOL LLC	FACILITY NUMBER: 434416282
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/29/2023

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 reviews, Staff #1 & #2 are missing current Mandated Reporter Training for Child Care Providers. This poses a potential risk to the health, safety or personal rights to children in care.
	POC Due Date: 04/12/2023
	Plan of Correction
1 2 3 4	Archana states she will submit current certificates for the two staff by 04/12/23.

Type B

Section Cited

CCR

101170(e)(2)

Criminal Record Clearance

(e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility: (2) Request a transfer of a criminal record clearance as specified in Section 101170(f) or This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, Staff #4 has been working at the facility without fingerprint clearance associated at this site. This poses a potential risk to the health, safety or personal rights to children in care. Civil penalty of $100 was assessed.
	POC Due Date: 03/30/2023
	Plan of Correction
1 2 3 4	Archana submitted Criminal Background Clearance Transfer Request (LIC 9182) to Licensing during the inspection. Deficiency corrected

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	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Marilou Monico	TELEPHONE: (408) 334-8549
LICENSING EVALUATOR SIGNATURE:	DATE: 03/29/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/29/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 03/29/2023 04:47 PM - It Cannot Be Edited

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: DELIGHT MONTESSORI PRESCHOOL LLC	FACILITY NUMBER: 434416282
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/29/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101216(g)(1)

Personnel Requirements

(1) Except as specified in (3) below, good physical health shall be verified by a health screening, including a test for tuberculosis, performed by or under the supervision of a physician not more than one year prior to or seven days after employment or licensure. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, Staff #1 is missing health screening report in the file. This poses a potential risk to the health, safety or personal rights to children in care.
	POC Due Date: 04/12/2023
	Plan of Correction
1 2 3 4	Archana states she will submit completed health screening for Staff #1 by 04/12/23.

Type B

Section Cited

CCR

101216.1(g)

Teacher Qualifications and Duties

(g) A photocopy of the teacher's Child Development Permit as specified in (c)(3) above, or a photocopy of the teacher's transcript(s) documenting successful completion of required course work, shall be maintained at the center. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on records review, Staff #1 is missing teacher's transcripts in the file. This poses a potential risk to the health, safety or personal rights to children in care.
	POC Due Date: 04/12/2023
	Plan of Correction
1 2 3 4	Archana agreed to submit transcripts for Staff #1 by 04/12/23.

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	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Marilou Monico	TELEPHONE: (408) 334-8549
LICENSING EVALUATOR SIGNATURE:	DATE: 03/29/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/29/2023

LIC809 (FAS) - (06/04)

Page: 4 of 6

Document Has Been Signed on 03/29/2023 04:47 PM - It Cannot Be Edited

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: DELIGHT MONTESSORI PRESCHOOL LLC	FACILITY NUMBER: 434416282
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/29/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101220.1(g)

Immunizations

(g) The licensee shall document each child's immunizations and shall maintain such documentation in the center for as long as the child is enrolled. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on records review, Child #3 & #4 are missing immunization records. This poses a potential risk to the health, safety or personal rights to children in care.
	POC Due Date: 05/29/2023
	Plan of Correction
1 2 3 4	Archana agreed to submit copy of completed California School Immunization Record for the two children by 05/29/23

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Marilou Monico	TELEPHONE: (408) 334-8549
LICENSING EVALUATOR SIGNATURE:	DATE: 03/29/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/29/2023

LIC809 (FAS) - (06/04)

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