434416691-12-14-2020-07-CC-SCOS-BWAP97-20201214100641

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434416691
Report Date: 10/29/2020
Date Signed: 12/14/2020 10:06:54 AM

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:	LITTLE VILLAGE PRESCHOOL, THE		FACILITY NUMBER:	434416691
ADMINISTRATOR:	CHANEL ROLAND		FACILITY TYPE:	850
ADDRESS:	14381 BERCAW LANE		TELEPHONE:	(408) 410-8845
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95124
CAPACITY:	30	CENSUS: 0	DATE:	10/29/2020
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	02:30 PM
MET WITH:			TIME COMPLETED:	03:09 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) Stephanie Collins conducted a scheduled Tele-Pre-Licensing inspection via video conference call with Chanel Roland, Director of The Little Village Preschool was informed that due to the COVID-19 situation and "Shelter in Place" Order, this LIC 809 Facility Evaluation Report will be generated at the Licensing Office and emailed to the facility. Facility’s reply to the email will serve as acknowledgement that the report was received. Applicant C. Roland is applying for a License to operate a Preschool Center with a capacity of 30. A Fire Clearance has been granted on 09/2/2020. The Preschool Center will operate Monday through Friday from 07:00AM to 06:00PM, serving children ages 2 years to entry into 1^st grade. Facility's phone # (408) 412-8655. LPA toured the indoor and outdoor, on limit and off limit areas. The measurements were taken by Chanel Roland and assistant LPA observed the process and provided direction over the video call. Indoor measurements are as follows: Per Evaluation Report 03/12/2009 Preschool Classroom = (Total sq. ft.) – (Total Encumbered Space) Classroom 1: (692 sq. ft) Classroom 2: (664.91sq.ft) Classroom 3: (669.36 sq. ft) Classroom 4: (787.50 sq. ft) – (9.47 sq. ft.)= 797.53 sq. ft Library (area) (174.48 sq. ft.) - (39.77 sq. ft.) = 134.71 *Total Preschool Indoor Activity Space = (2878.12 sq. ft.) divided by (35 sq. ft. / child) = 82 Preschool children* There are 7(105) sinks and 5 (75) toilets designated for Preschool children to use. Pp1

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Stephanie Collins	TELEPHONE: (408) 334-8555
LICENSING EVALUATOR SIGNATURE:	DATE: 10/29/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/29/2020

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 3

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: LITTLE VILLAGE PRESCHOOL, THE	FACILITY NUMBER: 434416691
	VISIT DATE: 10/29/2020

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
26
27
28
29
30
31
32

Pp2
Preschool Yard: Per Evaluation Report 03/12/2009
= (Total sq. ft.) – (Total Encumbered Space)
= (440.79 sq. ft) - (9.1 sq. ft.) = 431.69 sq. ft. + 3,505.23 sq. ft. + 2067.76 sq. ft.
=6,004.68 sq. ft.

Total Preschool Outdoor Activity Space = (6,004.68 sq. ft.) divided by (75 sq. ft. / child) = 80 Children
Water is available in the children's sinks. There are two staff restrooms located in the common area (near room 3), will also be used by children who become ill. Sick children will be isolated in room 3 and isolation equipment will be provided. The preschool will provide morning snacks and an afternoon snack. Parents and guardians are expected to provide lunch. Snacks will be prepared in the on-site kitchen. LPA observed that the kitchen is equipped with stoves, microwave, a sink with hot and cold running water, and a refrigerator. There are trash cans with tight fitted lids, and paper towels and hand soap near the sink. There are cubbies and hooks for children to store their belongings. Classrooms are furnished with age appropriate tables, chairs, play equipment, and toys. The facility has cots for children to use for napping. Facility staff will clean toys and equipment daily with cleaning wipes and solutions that will be kept inaccessible to children. Detergents, cleaning compounds, sharps, medicines, and other items which could pose a danger if readily available to children are stored where they are inaccessible to children in care. First aid supplies are stored inaccessible to children in each classroom with a main first aid box stored in kitchen area. LPA observed fully charged fire extinguishers, working carbon monoxide and fire detectors. The center will follow COVID-19 protocols and guidelines daily.

LPA observed two fully fenced- in play yards in the front and back of facility. The outdoor activity space is equipped with age-appropriate toys and equipment such as a play structure, sandbox and gardening area for children. Areas around and under climbing equipment have artificial grass (turf) and tanbark used as material that absorbs fall. Shade is provided by building overhang and canopy. The center will not provide transportation.

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Stephanie Collins	TELEPHONE: (408) 334-8555
LICENSING EVALUATOR SIGNATURE:	DATE: 10/29/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/29/2020

LIC809 (FAS) - (06/04)

Page: 2 of 3

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: LITTLE VILLAGE PRESCHOOL, THE	FACILITY NUMBER: 434416691
	VISIT DATE: 10/29/2020

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
26
27
28
29
30
31
32

Pp 3
The facility has a plan to provide Incidental Medical Services – IMS. The facility has submitted a Plan of Operation that includes IMS 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.

Director Chanel Roland has obtained a Clearance for Criminal Background and Child Abuse Index Checks, she also meets the education and experience qualification requirements and has completed and complied with Evaluation of Director Qualification/Passport. She has completed 16 hours of training on preventive health practices with Lead poisoning and the required pediatric cardiopulmonary resuscitation and pediatric first aid / Pediatric CPR/1st Aid Certification renewal date is 6/13/2022. Director has proof of immunity against Measles and Pertussis, and Health Screening with Tuberculosis clearance. Her Mandated Reporter Training for Child Care Provider Certification expires 02/13/2022.

LPA reminded director of the applicable civil penalties for those adults who have not received fingerprint clearances, are not associated to the license and who come in contact with or provide care and supervision to the children. Penalty amounts: $100.00 per person per day, minimum of $100.00 to a maximum of $500.00 per person for an initial violation and a minimum of $100.00 to a maximum of $3000.00 per person for any subsequent violation within a 12-month period.

Facility is encouraged to frequent the Department’s website at www.cdss.ca.gov to access resources for Providers, Regulations, Annual License fee, Adoption of new Laws, etc.

Exit Interview was conducted, where this report was reviewed with Director over a video conference.

Applicant was informed prior to approval the application for a Preschool Center License will be submitted for the final stage of review by Licensing Management.

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Stephanie Collins	TELEPHONE: (408) 334-8555
LICENSING EVALUATOR SIGNATURE:	DATE: 10/29/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/29/2020

LIC809 (FAS) - (06/04)

Page: 3 of 3