435700706-11-8-2023-52-CC-CURE-CXDTEY-20231108134044

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 435700706
Report Date: 11/08/2023
Date Signed: 11/08/2023 01:40:58 PM

Document Has Been Signed on 11/08/2023 01:40 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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME:	CUSD MONTCLAIRE CUPERDOODLE PRESCHOOL		FACILITY NUMBER:	435700706
ADMINISTRATOR:	ALICE CHAN		FACILITY TYPE:	850
ADDRESS:	1160 ST. JOSEPH AVENUE		TELEPHONE:	(408) 252-3000
CITY:	LOS ALTOS	STATE: CA	ZIP CODE:	94024
CAPACITY:	48	CENSUS:	DATE:	11/08/2023
TYPE OF VISIT:	Office	ANNOUNCED	TIME BEGAN:	11:30 AM
MET WITH:	Michelle Herriage & Yee "Alice" Chan		TIME COMPLETED:	01:45 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	On 11/08/2023 at 11:30am, Licensing Program Manager (LPM) Chandra Charles and Licensing Program Analyst (LPA) Christina Uribe met with facility representatives Michelle Herriage and Yee "Alice" Chan for the purpose of a conference meeting at the Oakland Regional Office for Community Care Licensing, Child Care Program. The purpose of today's meeting is to discuss the facility's day to day operations and roles and responsibilities of personnel. Michelle Herriage states that her role is Director of Educational Services for Cupertino Unified School District (CUSD). Alice Chan states that her role is Supervisor for Cuperdoodle Program for CUSD. On 09/01/23, LPA Uribe performed an unannounced annual required inspection at the facility. LPA cited 5 Type B Violations, 4 of which related to record keeping deficiencies. Some of the required documents (personnel records, children’s records, & required posted documents) were either missing or not up to date. LPA Uribe found that the facility’s deficiencies were seemingly due to lack of communication and understanding of roles amongst staff members. Additionally, the lack of communication seem to have been due to unclear understanding of the role of the director and their duties and responsibilities and who the director of the site is. The goal of today’s conference is to discuss the following; 1) Establish who the site director is & examine their role and responsibilities to oversee the day-to-day operations of the facility.; 2) Establish clear communication to keep all staff and administration of the facility well informed at all times of policies and procedures.; & 3) Establish a clear chain of command for facility procedures for record keeping of facility files. Page 1 of 2 *Continued on LIC 809C*

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Christina Uribe	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 11/08/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2023

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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: CUSD MONTCLAIRE CUPERDOODLE PRESCHOOL	FACILITY NUMBER: 435700706
	VISIT DATE: 11/08/2023

NARRATIVE

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Facility representatives established that Lilly Vazquez is the site director. LPA Uribe informed the facility representatives that all required documents for a director packet for Lilly have been obtained and LPA will assign Lilly as the site director in CCLD's profile for the facility. This orientation will be completed and the certificate will be emailed to LPA Uribe at christina.uribe@dss.ca.gov no later than the due date of 11/20/2023. Facility representatives have agreed to fulfilling these requirements as stated above to improve communication, record keeping, and understanding for all staff on facility roles and responsibilities.

Facility representatives and LPM/LPA discussed in length educational requirements to qualify a teacher.

Exit interview was conducted and report was reviewed with the facility representatives, Michelle Herriage & Yee "Alice" Chan.

Page 2 of 2 ***End of Report***

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Christina Uribe	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 11/08/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2023

LIC809 (FAS) - (06/04)

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