434417085-5-24-2023-07-CC-MSMS-CS5V83-20230524161202

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434417085
Report Date: 05/24/2023
Date Signed: 05/24/2023 04:12:11 PM

Document Has Been Signed on 05/24/2023 04:12 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:	AGAPE PLAYSKOOL		FACILITY NUMBER:	434417085
ADMINISTRATOR:	ADLIN SOFIA NETTO		FACILITY TYPE:	850
ADDRESS:	3700 THOMAS ROAD, SUITE 107		TELEPHONE:	(669) 295-8697
CITY:	SANTA CLARA	STATE: CA	ZIP CODE:	95054
CAPACITY:	30	CENSUS: 0	DATE:	05/24/2023
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	01:10 PM
MET WITH:	Adlin Sofia Netto		TIME COMPLETED:	04:20 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) Mel Matos & Anna Morales, conducted an announced prelicensing inspection at the facility today. Purpose of today's inspection: address new application request for a preschool license submitted by the Applicant Representative. LPAs met with Adlin Sofia Netto, Applicant Representative/Director, and explained the nature of today's inspection to her. LPAs note that the Facility is located in Suite 107 on the bottom floor. The Applicant Representative is applying for a license to serve 30 preschool children ages 2 to 5 years of age. The Facility will operate Monday through Friday from 8:30 AM - 5:30 PM. LPAs toured and measured the indoor and outdoor areas of the Facility during today's inspection. Indoor Activity Space: Lobby Play Area = 14.000 x 8.250 = 115.500 Classroom 1 = 17.333 x 20.333 = 352.431 Classroom 2 = 32.417 x 12.500 = 405.212 *TOTAL INDOOR SPACE = 873.143 sq. ft. divided by 35 = 24 children* Facility has 2 sinks (30) and 2 toilets (30) available for the preschool children in the Facility. LPAs reminded Adlin that the children's bathroom door will need to remain open to allow for children to be adequately supervised while in the bathroom. The sinks used by the preschool children have hot/cold running water. Adlin understands that the hot water temperature in the bathroom sinks must be less than 120 degrees Fahrenheit at all times. Staff have one separate bathroom within the Facility. The staff bathroom will be utilized by sick children if needed. Sick children will be isolated in the office area of the Facility and isolation equipment will be provided.

SUPERVISOR'S NAME: Diana Stephenson	TELEPHONE: (408) 324-2158
LICENSING EVALUATOR NAME: Melvin S Matos	TELEPHONE: (408) 334-8554
LICENSING EVALUATOR SIGNATURE:	DATE: 05/24/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/24/2023

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: AGAPE PLAYSKOOL	FACILITY NUMBER: 434417085
	VISIT DATE: 05/24/2023

NARRATIVE

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All Classrooms have appropriate lighting, central heating/air conditioning, and ventilation. There no wall heater or fireplace units in the Facility. First aid supplies are stored in the Facility inaccessible to children. Cleaning supplies are stored throughout the Facility and inaccessible to children. Adlin states that there no poisons at the Facility. LPAs observed solid waste containers with tight-fitting lids in the Facility. The Facility has functioning smoke and carbon monoxide detectors. Adlin states that the Facility will not administer medications at this time.

There are 6 tables, 28 chairs, 30 cubbies, and 27 cots for the children. There is adequate equipment, supplies, and toys for children in each Classroom. Drinking water will be readily available for the children indoors via reusable water bottles & refill water station. Transportation will not be provided by the Facility.

Adlin states that the Facility will provide AM/PM snacks & lunch for the children. The Facility has reusable plates, utensils, and cups for the children. The Facility has a food preparation area which has a refrigerator, microwave, rice cooker, skillet, and cold running water. Adlin agreed to have hot water available in the food preparation area. Adlin understands that any food brought from home shall be labeled with each child's name and properly stored.

Outdoor Space (Playground):

40.333 x 22.333 = 900.756

TOTAL OUTDOOR SPACE = 900.756 sq. ft. divided by 75 = 12 children

Adlin provided LPAs with a playground waiver request (lack of sufficient space) along with usage schedules during today's inspection.

The preschool playground to be used by the children is surrounded by appropriate fencing. LPAs note that the self-closing playground exit gate opens out to the parking lot which is shared with other businesses within the complex. Adlin agreed to install a portable alarm on the playground as an extra layer of security. The outdoor surfaces are safe for the children. There is adequate equipment, supplies, and toys for children in the preschool playground. Shade is provided by the building overhang. There are no play structures in the playground. Drinking water will be readily available for the children outdoors via reusable water bottles which the Facility will refill as needed. LPAs observed no bodies of water in the playground area of the Facility.

SUPERVISOR'S NAME: Diana Stephenson	TELEPHONE: (408) 324-2158
LICENSING EVALUATOR NAME: Melvin S Matos	TELEPHONE: (408) 334-8554
LICENSING EVALUATOR SIGNATURE:	DATE: 05/24/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/24/2023

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: AGAPE PLAYSKOOL	FACILITY NUMBER: 434417085
	VISIT DATE: 05/24/2023

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Adlin Netto, Applicant Representative/Director, 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, 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.

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 platform. 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.

A fire clearance approval for 30 children was received from the Santa Clara Fire Dept. prior to today's inspection.

LPAs conducted an exit interview with Adlin Netto, Applicant Representative/Director, and advised her that a license for 24 preschool children will be approved upon completion of the following:

1) Revised Application for a Child Care Center (LIC 200A) has been approved.

2) Updated fire clearance approval for 24 children has been received.

3) Waiver request for lack of sufficient playground space has been approved.

4) Portable alarm has been installed on the self-closing playground exit gate.

5) Hot water is available in the food preparation area.

SUPERVISOR'S NAME: Diana Stephenson	TELEPHONE: (408) 324-2158
LICENSING EVALUATOR NAME: Melvin S Matos	TELEPHONE: (408) 334-8554
LICENSING EVALUATOR SIGNATURE:	DATE: 05/24/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/24/2023

LIC809 (FAS) - (06/04)

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