434417305-5-22-2023-07-CC-MMOO-CS42K3-20230522172715

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434417305
Report Date: 05/22/2023
Date Signed: 05/22/2023 05:27:23 PM

Document Has Been Signed on 05/22/2023 05:27 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:	BUILDING KIDZ OF SANTA CLARA		FACILITY NUMBER:	434417305
ADMINISTRATOR:	MIAO LI		FACILITY TYPE:	830
ADDRESS:	1500 LOS PADRES BLVD,#110,#111		TELEPHONE:	(408) 758-8804
CITY:	SANTA CLARA	STATE: CA	ZIP CODE:	95050
CAPACITY: 12	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	05/22/2023
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Miao Li, Carolynn Myers, & Jamie Brown		TIME COMPLETED:	05:40 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) Marilou Monico and Jovani Dhillon met with Site Director/Applicant Representative, Miao Li, Account Manager/Consultant, Carolynn Myers, and Director of Operations, Jamie Brown, for the purpose of conducting a Prelicensing Inspection. Fire clearance was approved on March 28, 2023. The Infant Program will be operating Monday through Friday from 7:00 AM to 6:00 PM, serving children ages 6 weeks to 2 years old. LPAs toured the facility during today's inspection as well measured the space available for the children. The following are indoor measurements and information: Building 111 Infant Room: 21.417 x 14.833 = 317.678 12.583 x 10.833 = 136.311 Infant Room total = 453.989 minus 33.071 (encumbered space) = 420.918 *TOTAL INFANT INDOOR SPACE = 420.918 sq. ft. divided by 35 = 12 children* The Infant Program has one sink (15) available for the children. Only cold water in the children's sink. LPAs observed a diaper changing table in the Infant Room that is within arm's reach of a portable sink. The portable sink will only be used by staff after changing children's diapers. There is a staff bathroom located adjacent to the reception area. Sick children will be isolated in the reception area and isolation equipment will be provided. Sick children will use the staff bathroom if needed and will accompanied by a staff member. The staff bathroom is clean, sanitary, and operable. *Continuation on Pages 2 & 3:*

SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Marilou Monico
LICENSING EVALUATOR SIGNATURE:	DATE: 05/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2023

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: BUILDING KIDZ OF SANTA CLARA	FACILITY NUMBER: 434417305
	VISIT DATE: 05/22/2023

NARRATIVE

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LPAs observed containers with tight-fitting lids for the disposal of solid waste and diapers. First aid supplies, medication, and cleaning products are stored in the upper cabinets in the Infant Room. LPAs observed smoke and carbon monoxide detectors at the facility. The facility has central heating and air conditioning.

Site Director understands that the facility must be kept free of flies, other insects & rodents. LPAs observed that all furniture and equipment indoor are in good condition and safe for the children. Drinking water will be readily available for the children indoor via sippy cups and bottles. The parents will be providing snacks and lunch for the children. There is a kitchen at the facility located adjacent to the Toddler Room in Building 111. The kitchen is equipped with a sink that has hot and cold running water, oven, stove, microwave, refrigerator, and dishwasher. The kitchen has plenty of storage spaces. Disposable dishes and utensils will be utilized by the facility.

There are 4 chairs, 1 table, 4 high chairs, 5 cribs, 7 mats, and 12 cubbies available for the infants.

The following are outdoor measurements and information:
Infant Playground : 44.167 x 24.000 = 1,060.008 minus 184.685 (encumbered space) = 875.323
TOTAL INFANT OUTDOOR SPACE = 875.323 sq. ft. divided 75 sq. ft. = 11 children

LPAs observed that the Infant Playground is surrounded by appropriate fencing and the outdoor surfaces are safe. Shades are provided by sunshade sail and awning. Drinking water outdoor is via sippy cups and bottles. No bodies of water were observed.

This facility plans to provide Incidental Medical Services – IMS. For IMS information, see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. A Plan of Operation that includes IMS was 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)/ (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.

Continuation on Page 3

SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Marilou Monico
LICENSING EVALUATOR SIGNATURE:	DATE: 05/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2023

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: BUILDING KIDZ OF SANTA CLARA	FACILITY NUMBER: 434417305
	VISIT DATE: 05/22/2023

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Site 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.

LPAs discussed the safe sleep regulations with Site Director and discussed the Child Care Licensing Safe Sleep webpage athttps://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPAs informed Site Director of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

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

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.

The following documents were submitted during the inspection:

1) Waiver request to allow licensure of 12 children in the Infant Program even though the playground is only measured for 11 children and staggered playground schedule.

Exit interview conducted and report was reviewed with Miao Li, Site Director, and Carolynn Myers, Account Manager/Consultant. LPAs advised Miao and Carolynn that a license for 12 children in the Infant program will be submitted to Licensing Management for the final stage of approval.

SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Marilou Monico
LICENSING EVALUATOR SIGNATURE:	DATE: 05/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2023

LIC809 (FAS) - (06/04)

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