434417077-6-28-2023-07-CC-SYIP-CT8V3J-20230628160448

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434417077
Report Date: 06/28/2023
Date Signed: 06/28/2023 04:04:53 PM

Document Has Been Signed on 06/28/2023 04:04 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:	MARIPOSAS PRESCHOOL		FACILITY NUMBER:	434417077
ADMINISTRATOR:	VANESSA VALDEZ		FACILITY TYPE:	850
ADDRESS:	16900 DE WITT AVENUE		TELEPHONE:	(408) 209-4648
CITY:	MORGAN HILL	STATE: CA	ZIP CODE:	95037
CAPACITY: 52	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	06/28/2023
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	09:25 AM
MET WITH:	Julio Valdez and Vaness Valdez		TIME COMPLETED:	02:30 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) Samantha Yip and Ashley Lopez conducted an announced pre-licensing inspection. LPAs met with Applicant's spouse, Julio Valdez, and explained the reason of the inspection. Applicant Vanessa Valdez arrived shortly after. The purpose of this inspection is Applicant is applying for a preschool license for a capacity of 51 children. A fire clearance was granted on 06/15/2023. There is a working phone at the center. The hours of operation are Monday through Friday 7:30AM to 5:30PM. There is an area to post required postings, such as notification of parent's rights, car seat, personal rights, and LIC 999. LPA toured the inside and outside of the center. Measurements were conducted during today's inspection. The indoor space measurements are as followed: Classroom 1: (18.750 x 27.417 = 514.068) + (14.167 x 20.500 = 290.423) + (5.500 x 18.667 = 102.668) = 907.159 minus encumbered space 31.287 = 875.872 Classroom 2: 12.083 x 16.333= 209.111 Classroom 3: (11.333 x 11.833 = 134.103) + (15.083 x 21.167 = 319.261) + (5.167 x 9.500 = 49.086) + (6.500 x 11.833 = 76. 914) = 579.364 minus encumbered space 24.981 = 554.383 Library: 16.083 x 9.583 = 154.123 = 875.872 + 209.111 + 554.383 + 154.123 = 1793.489 TOTAL INDOOR SPACE: 1,793 divided by 35 = 51 children -----------------continues on 809 dated 06/28/2023 page 2--------------------------

SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Samantha Yip
LICENSING EVALUATOR SIGNATURE:	DATE: 06/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/28/2023

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: MARIPOSAS PRESCHOOL	FACILITY NUMBER: 434417077
	VISIT DATE: 06/28/2023

NARRATIVE

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---------------continuation of 809 dated 06/28/2023 page 1---------------------

The outdoor space measurements are as followed:
(8.500 x 14.667 = 124.669) + (31.750 x 38.833 = 1232.947) + (59.417 x 16.500= 980.380) + (62.750 x 65.250 = 4,094.437) = 6432.433 minus encumbered space 949.318 = 5,483.115
Total Outdoor Space: 5,483.115 divided by 75 = 73 children

There are 21 tables, 62 chairs, 72 hooks, 88 cubbies, four (4) toilets, seven (7) sinks, 13 mats, and 38 cots. Sinks for children only have cold water. There are toys for children, which are age appropriate. There is a fully charged fire extinguisher, smoke detector, and carbon monoxide detector. Applicant Vanessa stated that there are no weapons, such as firearms, stored on the premise. There is a first aid kit, which has all the required items. The isolation area for sick children will be in the Director's office and will be using staff bathroom for sick children. LPA discussed with Applicant about supervision and that children need to be visually supervised at all times.

The outdoor activity space is fenced. There is resilient material around play structure. LPAs observed that the tan bark in the playground behind the Library was low and there was not enough tan bark below the slide in the playground to the left of Classroom 3. LPAs also observed that the rubber mulch in the playground to left of Classroom 3 has patches. Shaded rest area is provided through canopy and trees. There were no bodies of water observed during today's inspection. LPA discussed with Applicant about washing the play structure. LPAs observed that there is a wire that is hanging from the power line into the outside area.

The center will only be providing snacks to children. LPA discussed with Applicant that the menu needs to be posted. All meals will be prepared and brought from home. The center will be using the Kitchen in Classroom 1. LPA discussed with Applicant that sinks for food preparation need to have hot and cold running water. Drinking water will be provided through the water fountains outside and water jugs. LPAs discussed that they have 180 days after licensure to receive lead testing for drinking water or food preparation. Trash can for waste have tight fitted lids.

----------------continuation of 809 dated 06/28/2023 page 3---------------------

SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Samantha Yip
LICENSING EVALUATOR SIGNATURE:	DATE: 06/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/28/2023

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: MARIPOSAS PRESCHOOL	FACILITY NUMBER: 434417077
	VISIT DATE: 06/28/2023

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-----------------continuation of 809 dated 06/28/2023 page 2-----------------------

This facility plans to provide Incidental Medical Services – IMS. For IMS information, see PIN 22-02-CCP. A 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) or (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.

LPA reviewed with applicant the LIC 311A, Records to Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted.

Applicant was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, 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.

Applicant was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms.
To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

Exit interview conducted and report was reviewed with the Applicant, Vanessa Valdez. LPAs advised facility representatives upon approval of Licensing Management, a license for a preschool center license will be granted and issued to Applicant and completion of the following:
- fingerprints transferred to facility
- required postings are posted
- additional tan bark installed in playground
- wire hanging from the power line outside is out of reach

SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Samantha Yip
LICENSING EVALUATOR SIGNATURE:	DATE: 06/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/28/2023

LIC809 (FAS) - (06/04)

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