434417006-10-19-2021-07-CC-DMAC-C7XV6F-20211019160927

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434417006
Report Date: 10/19/2021
Date Signed: 10/19/2021 04:09:36 PM

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:	ELITE INTERNATIONAL SCHOOL LLC		FACILITY NUMBER:	434417006
ADMINISTRATOR:	BONNIE LI		FACILITY TYPE:	850
ADDRESS:	2555 MOORPARK AVENUE		TELEPHONE:	(415) 596-9213
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95128
CAPACITY:	100	CENSUS: 0	DATE:	10/19/2021
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	09:37 AM
MET WITH:	Bonnie Li		TIME COMPLETED:	02:40 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) Dung Mac and Marilou Monico, conducted an announced pre-licensing inspection to the Facility today. LPAs met with Bonnie Li, Applicant Representative/Site Director, and explained the nature of today's inspection. The facility will operate Monday through Friday from 07:30 AM to 05:30PM, serving children ages 2 years to entry into kindergarten. LPAs toured and measured the indoor and outdoor areas of the Facility during today's inspection. INDOOR MEASUREMENTS ARE AS FOLLOWS: Room 1 = (16.750 x 11.250) + (31.750 x 14.250) - (10.750 x 5.083) encumbered = 640.874 - 54.642 = 586.232 Room 2 = (15.917 x 12.667) + (20.500 x 13.750) - (2.250 x 1.083) encumbered = 483.495 - 2.436 = 481.059 Room 3 = (21.333 x 19.333) - (2.500 x 1) encumbered = 412.430 - 45.841 = 366.589 Room 4 = (21.000 x 17.250) - (2.000 x 9.000) encumbered = 362.25 - 18.000 = 344.250 Room 5 = 22.750 x 12.417 = 283.486 Room 6 = (22.833 x 22.167) - (1.750 x 0.750) encumber = 506.139 - 1.312 = 504.827 Room 7 = (9.250 x 13.000) + (7.000 x 6.667) + (10.000 x 7.917) = 250.25 + 79.17 + 46.669 = 376.089 Preschool Indoor Space Total = 2,941.532 sq. ft. divided 35 sq. ft. = 84 children Continuation on Page # 2

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Dung Mac	TELEPHONE: (408) 334-8546
LICENSING EVALUATOR SIGNATURE:	DATE: 10/19/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2021

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: ELITE INTERNATIONAL SCHOOL LLC	FACILITY NUMBER: 434417006
	VISIT DATE: 10/19/2021

NARRATIVE

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There are 10 sinks (150), 5 toilets (75), and 2 urinals (30) available for children to use. The sinks used by children only have cold running water. There are 14 tables, 60 mats, 62 chairs, and 78 cubbies. Some of the children will be attending on a part-time basis. LPAs observed containers with tight-fitting lids for solid waste. The Facility has barricaded wall heaters, space heaters, and air-conditioning. All classrooms have appropriate lighting. Drinking water is available via individual water bottle indoors and water dispenser and plastic cups.

LPAs observed functioning smoke/carbon monoxide detectors at the facility. Cleaning supplies will be stored on high shelves in kitchen inaccessible to children. First aid supplies and medications will be stored in the office. There is adequate equipment, supplies and toys for the children in each classroom. The facility has a separate staff bathroom located in Room 1 that will be utilized by sick children if necessary. Sick children will be isolated in the office and isolation equipment will be provided.

The facility will be providing AM/PM snacks. Children will bring their own lunch. There is a kitchen on-site and the food preparation area is functional and has hot and cold running water, sink, microwave, and storage space for food. Cleaning and sanitation of dishes and utensils will be done via dishwasher. Plastic utensils and plates will be utilized by the Facility. Transportation will not be provided. Bonnie states that there are no weapons on the premises.

OUTDOOR MEASUREMENTS:
(63.000 X 105.000) - 432.331 (encumbered) = 6,515.000 minus 432.331 (encumbered space) = 6182.669
TOTAL OUTDOOR SPACE = 6,182.669 sq. ft. divided by 75 sq. ft. = 82 children

The playground area utilized by children is surrounded by appropriate fencing. LPAs observed that the outdoor equipment is age appropriate. There are climbing structures in the yard with wood chips for resilient material. Shade is provided by large trees, canopies, and building overhangs. Drinking water is provided by individual water bottles. LPAs observed no bodies of water.

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SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Dung Mac	TELEPHONE: (408) 334-8546
LICENSING EVALUATOR SIGNATURE:	DATE: 10/19/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2021

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: ELITE INTERNATIONAL SCHOOL LLC	FACILITY NUMBER: 434417006
	VISIT DATE: 10/19/2021

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Bonnie Li, Applicant Representative/Site Director, have obtained a Criminal Records Clearance and Child Abuse Index Checks. Bonnie's Pediatric First Aid/CPR Certifications expire June 2023. Bonnie has proof of completion of Preventative Health Practices and immunization in Measles and Pertussis and Influenza on file.

LPAs reminded Bonnie of the applicable civil penalties for those adults who have not received fingerprint clearances, are not associated to the facility, and who come in contact with or provide care and supervision to the children. For an initial violation, civil penalty amounts to $100.00 per person per day up to $500.00 per person. For a subsequent violation within a 12-month period, civil penalty amounts to $100.00 per person up to $3000.00 per person.

This facility plans to provide Incidental Medical Services – IMS. A Plan of Operation that includes IMS has been submitted to the Department. 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

During the inspection, Applicant revised the Application for Child Care Center License (LIC 200A) to change the requested capacity from 100 to 82 children.

LPAs conducted an exit Interview and advised Bonnie that a license for 82 preschool children will be approved upon completion of the following items:
1) Furnace closet located in Room 7 and in the playground must be inaccessible to children.
2) The wooden climbing structure in the playground has chipping paint on the stairs and flooring. Applicant states she will repaint the stairs and flooring.
3) Remove/fix the broken canopy in the playground.
4) Repaint the handles and remove the tripping hazards on the stairs of the blue climbing structure on the playground.
5) The playground areas must be free of clutters and fix the missing fence boards.
6) Site Director is lacking one unit in Administration/Staff Relations course and will submit a request an exception along with a proof of registration.
7) Site Director will submit a TB test (not more than one year old).

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Dung Mac	TELEPHONE: (408) 334-8546
LICENSING EVALUATOR SIGNATURE:	DATE: 10/19/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2021

LIC809 (FAS) - (06/04)

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