<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434417009
Report Date: 11/05/2021
Date Signed: 11/08/2021 12:46:25 PM

Document Has Been Signed on 11/08/2021 12:46 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:NOAH'S ARK CHILDREN LEARNING CENTERFACILITY NUMBER:
434417009
ADMINISTRATOR:CHIAYI LIFACILITY TYPE:
850
ADDRESS:560 HARRISON AVENUETELEPHONE:
(408) 691-3808
CITY:CAMPBELLSTATE: CAZIP CODE:
95008
CAPACITY: 24TOTAL ENROLLED CHILDREN: 0CENSUS: 9DATE:
11/05/2021
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:ChiaYi LiTIME 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 Analysts (LPAs) Dung Mac and Mel Matos, conducted an announced pre-licensing inspection (change of ownership) to the Facility today. LPAs met with ChiaYi Li, Applicant Representative, and Amie Oman, Site Director, and explained the nature of today's inspection to them. The Facility is still in operation (Facility #434407994) pending the approval of the change of ownership. Note: Applicant Representative has applied for a Preschool (#434417009) and Infant with Toddler Option (#434417010) on the same premises.

The Preschool Center will operate Monday through Friday from 8:00AM to 5:00PM, serving Preschool children ages 2 years to entry into first grade. The Preschool program will be using Rooms 1 & 2 and the Infant program will be utilizing Rooms 3 (Toddler Room) & 4 (Infant Room).

A fire clearance approval from the Santa Clara County Fire Department for 24 preschool children was received prior to today's inspection. LPAs toured and measured the indoor and outdoor areas of the facility during today's inspection.

INDOOR ACTIVITY SPACE:

PRESCHOOL ROOM #1:
21.000 x 11.750 = 246.750
9.333 x 8.083 = 75.438
(14.000 x 10.250) minus (4.583 x 3.583) (encumbered) = 143.5 - 16.420 = 127.08 Room 1 Total = 246.750 + 75.438 + 127.08 = 449.268 sq. ft.


Report To Be Continued on Page #2
SUPERVISORS NAME: Sandy Knight
LICENSING EVALUATOR NAME: Dung Mac
LICENSING EVALUATOR SIGNATURE: DATE: 11/05/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/05/2021
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 4
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: NOAH'S ARK CHILDREN LEARNING CENTER
FACILITY NUMBER: 434417009
VISIT DATE: 11/05/2021
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
 PRESCHOOL ROOM #2 = 20.000 x 13.167 = 263.340
5.667 x 5.083 = 28.805
Room 2 Total = 263.340 + 28.805 = 292.145 sq. ft.

TOTAL PRESCHOOL INDOOR SPACE = 741.413 sq. ft. divided by 35 = 21 children

Facility has 3 sinks (45) and 2 toilets (30) available for the preschool children. The sinks used by children have hot (less than 120 degrees F) and cold running water. ChiaYi understands that the hot water temperature must be less than 120 degrees Fahrenheit. The Staff bathroom is clean and sanitary and can be utilized by sick children if necessary. Sick children will be isolated in the director's office and isolation equipment will be provided. ChiaYi states that there are no weapons or firearms on the premises.

Medications will be stored in the kitchen on high shelf inaccessible to children. First aid supplies (including touch less thermometer) and cleaning supplies are stored on a high shelf inaccessible to children.

LPAs observed a solid waste container with a tight-fitting lid and functioning smoke/carbon monoxide detectors in both classrooms. Facility has adequate toys and activities for children. A fireplace in Room 1 was covered. LPAs did not observe wall heaters at the Facility. Both classrooms have appropriate lighting.

There are 4 tables, 24 chairs, 33 hooks, and 24 mats. Drinking water indoors/outdoors is via individual water bottles/filtered water. Transportation will not be provided by the Facility.

Breakfast, lunch, AM/PM snacks will be provided by the center. There is an off-limits kitchen for food preparation. The food preparation area (kitchen) is functional and has hot and cold running water, sink, refrigerator, stove, and storage spaces for food. Cleaning and sanitation of dishes and utensils will be done via hand washing.


Report To Be Continue on Page #3
SUPERVISORS NAME: Sandy Knight
LICENSING EVALUATOR NAME: Dung Mac
LICENSING EVALUATOR SIGNATURE:

DATE: 11/05/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/05/2021
LIC809 (FAS) - (06/04)
Page: 2 of 4
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: NOAH'S ARK CHILDREN LEARNING CENTER
FACILITY NUMBER: 434417009
VISIT DATE: 11/05/2021
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
OUTDOOR MEASUREMENTS:

FRONT PLAYGROUND:
(40.833 x 28.667) minus (3.833 x 2.250) (encumbered space)
= 1,170.560 minus 8.62 = 1,161.940 sq. ft.

BACK PLAYGROUND:
(47.333 x 25.000) minus (5.917 x 5.000) (encumbered) + (60.833 x 12.333)
= 1,183.325 - 29.585 = 35,008.760 + 750.253 = 1,903.993 sq. ft

TOTAL OUTDOOR SPACE = 3,065.93 sq. ft. divided by 75 = 40 children

Front and back preschool playground is exclusively for the Preschool program and are surrounded by appropriate fencing. The areas around and under the play structures are cushioned with material (rubber chips) that absorbs falls. The playground equipment is age appropriate. Shade is provided by patio covering and canopy. There are adequate equipment, supplies, and toys for children outdoors. ChiaYi states that Toddler Option and Preschool Program will share Preschool playground, but at different time intervals.

LPAs observed the bottom gap of the front gate and the steel fence facing the street in the front playground is 5 inches. There is a five inch gap between the chain link fence and the steel fence in the front preschool playground that needs to be closed up. The area surrounding the sandbox (frame area closest to the fence) has chipped wood which needs to be repaired or replaced.

ChiaYi Li, Applicant Representative, and Amie Oman, Director, have obtained a Criminal Records Clearance and Child Abuse Index Checks. Director has met the education and experience qualification requirements and her Pediatric First Aid/CPR Certifications expire on 9/2023. Director has proof of completion of Preventative Health Practices and proof of immunity against Measles and Pertussis, Influenza on file.


Report To Be Continued on Page #4
SUPERVISORS NAME: Sandy Knight
LICENSING EVALUATOR NAME: Dung Mac
LICENSING EVALUATOR SIGNATURE:

DATE: 11/05/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/05/2021
LIC809 (FAS) - (06/04)
Page: 3 of 4
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: NOAH'S ARK CHILDREN LEARNING CENTER
FACILITY NUMBER: 434417009
VISIT DATE: 11/05/2021
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
LPAs reminded ChiaYi Li 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.

Incidental Medical Services (IMS) policy was discussed. When any IMS is provided, an updated Plan of Operation that includes IMS must be 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.

LPAs conducted an exit Interview and advised ChiaYi, Applicant Representative, that a license for 21 Preschool children will be submitted to Licensing Management for the final stage of approval upon receiving the of following documents:
1) The entry gate accessing to the front playground needs a latch.
2) The bottom gap of the front gate and the steel fence facing the street in the front
preschool playground needs to be 3 1/2 inches or less.
3) The five inch gap between the chain link fence and the steel fence in the front
preschool playground needs to be closed up.
4) Waiver request and playground schedules for the Toddler Program to share the Preschool
Yard.
5) Updated indoor sketch.
SUPERVISORS NAME: Sandy Knight
LICENSING EVALUATOR NAME: Dung Mac
LICENSING EVALUATOR SIGNATURE:

DATE: 11/05/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/05/2021
LIC809 (FAS) - (06/04)
Page: 4 of 4