434413036-12-20-2021-52-CC-MESA-C9VTM6-20211220135037

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434413036
Report Date: 12/20/2021
Date Signed: 12/20/2021 01:50:45 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME:	GLOBAL VILLAGE MONTESSORI		FACILITY NUMBER:	434413036
ADMINISTRATOR:	SELVASUMATHI NAMOKAREAN		FACILITY TYPE:	850
ADDRESS:	1146 JACKLIN ROAD		TELEPHONE:	(408) 956-8711
CITY:	MILPITAS	STATE: CA	ZIP CODE:	95035
CAPACITY:	72	CENSUS: 45	DATE:	12/20/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:40 AM
MET WITH:	DIRECTOR: SELVASUMATHI NAMOKAREAN		TIME COMPLETED:	02:00 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	On Monday, December 20, 2021 at 10:40am, Lincensing Program Analyst (LPA) Manel Estoesta conducted an unannounced Required One (1) Year visit. LPA met with the facility representative DIRECTOR: SELVASUMATHI NAMOKAREAN and explained the nature of site visit. Present on this visit were 45 preschool children and 8 staff. Facility operates from Monday to Friday 8am to 5:30pm. LPA toured the facility to conduct a Health and Safety Inspection with the Director. LPA observed that all rooms are clean and safe for all children and staff. The Facility has three active rooms which are the Penguin Room, Dolphin Room and Turtle Room. The facility have a waiver available for outdoor activity space and for electronic sign in/out which was observed to be posted together with the Facility’s License, Parents’ Rights Poster, Personal Rights, and Activity Schedules. LPA inspected the playground and the restrooms. Disinfectants, cleaning solutions, and other items that are dangerous to children were stored inaccessible to children. Furniture and equipment such as mats, cots, tables, and chairs were age appropriate and were in good condition, free of sharp, loose, or pointed parts. Restroom for children's use was observed to be in operating condition. Facility floors were clean. Director stated that facility does not possess nor store any weapons on the premises. Outdoor activity space is fenced and play equipment were maintained in a safe condition and free of hazards. There were no bodies of water observed. Areas around and under high climbing equipment and slides were cushioned with material that absorbs falls. Drinking water is arranged to be readily available to children during indoor and outdoor activities. The facility only provides snacks. Snack menu was posted. Food storage area were clean, free of litter, rubbish, and rodents/vermin. Foods and beverages were kept protected against contamination and spoilage. Trash cans for solid waste had tight-fitting covers on, and were in good repair. Facility does not provide transportation but Director understands that children cannot be left alone, unattended in park vehicles. SEE 809 C.......

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Manel Estoesta	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 12/20/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2021

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 3

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: GLOBAL VILLAGE MONTESSORI	FACILITY NUMBER: 434413036
	VISIT DATE: 12/20/2021

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

CONTINUATION....

First Aid Kit was inspected. Fire extinguisher was last serviced on OCTOBER 2021. Facility had a Fire Department Annual Inspection on 08/04/2021. Fire and Earthquake Drills were last conducted on 11/05/2021 and 12/07/2021, respectively.

Facility files were reviewed. Child sign in and out procedures and logs were reviewed. A sample of children files was taken for review. Records reviewed include Admission Agreement, Identification and Emergency Information, Medical Assessment, Consent for Emergency Medical Treatment form, and Immunization.
Staff files were reviewed, which included records of: Criminal Record and Child Abuse Index Clearance, TB Clearance, documented proof of immunity against Pertussis and Measles, Education Qualification, and required Training such as the AB1207 Mandated Reporter Training. LPA reminded Director that the AB1207 training needs to be renewed every two years. There was at least one person with documented training on preventive health practices, including current certification in Pediatric CPR and First Aid present at the facility.

LPA discussed the following;
1. PIN 21-21-CCP RELEASE OF THE WRITTEN DIRECTIVES FOR LEAD TESTING OF WATER IN LICENSED CHILD CARE CENTERS PER AB 2370
https://cdss.ca.gov/inforesources/child-care-licensing/water-testing-information

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 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)/ (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

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process. SEE 809 C....

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Manel Estoesta	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 12/20/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2021

LIC809 (FAS) - (06/04)

Page: 2 of 3

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: GLOBAL VILLAGE MONTESSORI	FACILITY NUMBER: 434413036
	VISIT DATE: 12/20/2021

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

CONTINUATION....

Facility representative was reminded that all adults 18 and over, 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.

For licensing updates, please email childcareadvocatesprogram@dss.ca.gov and request to be added to the email list. Previous Provider Information Notices (PINs) - Child Care Licensing Program (CCLP) are available at the CCLD website and other helpful information at https://cdss.ca.gov/inforesources/child-care-licensing.

If you would like to report an Unusual Incident, please call our Main Office (510) 622 – 2602, there would be two (2) Desk Duty Analyst that are available to assist you.

No regulatory violations were observed at the time of the visit.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the DIRECTOR: SELVASUMATHI NAMOKAREAN.

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Manel Estoesta	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 12/20/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2021

LIC809 (FAS) - (06/04)

Page: 3 of 3