075700615-10-10-2023-52-CC-MOTI-CWH246-20231010170325

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 075700615
Report Date: 10/10/2023
Date Signed: 10/10/2023 05:03:36 PM

Document Has Been Signed on 10/10/2023 05:03 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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME:	LITTLE BUTTERFLIES SAN RAMON, THE		FACILITY NUMBER:	075700615
ADMINISTRATOR:	KRISHNAKUMAAR, JANANI		FACILITY TYPE:	840
ADDRESS:	2691 CROW CANYON ROAD		TELEPHONE:	(410) 562-8852
CITY:	SAN RAMON	STATE: CA	ZIP CODE:	94583
CAPACITY: 22	TOTAL ENROLLED CHILDREN: 22	CENSUS: 0	DATE:	10/10/2023
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	01:45 PM
MET WITH:	Janani Krishnakumar		TIME COMPLETED:	05:20 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	A Prelicensing Visit was conducted today 10/10/2023 by Licensing Program Analyst (LPA) Melanie Otsuji. LPA met today with Applicant, Janani Krishnakumar. The Licensee has submitted an application for a change in ownership of a school-age license. Also on site is a preschool with toddler option component (max cap: 55) and infant component (max cap: 7). A health and safety inspection was conducted inside and outside. The school age program will operate in 1 classroom. Operating hours Monday through Friday from 8AM - 6PM. The measurements of classroom was taken previously and is as follows: INDOORS: 785.82 square feet = 22 children OUTDOORS: 14727.39 square feet = 196 children A fire clearance is approved by the San Ramon Valley Fire on 9/25/2023. The school age classroom will be Building 2. The classroom is equipped with age appropriate materials and equipment. The yard is fenced in all around and there are climbing structures. Tanbark is under high climbing equipment. There is shade available for the children in the play yard. There are sinks and toilets available for children and provide privacy. The facility serves AM/PM snacks with children bringing lunch from home. Drinking water is available inside and outside. The center has first aid supplies available. Carbon monoxide and smoke detector is hardwired. Facility utilizes an electronic sign in/out program. The center director, Theresa Gross has completed 16 hours of health and safety training including pediatric CPR and First Aid.

SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Melanie Otsuji
LICENSING EVALUATOR SIGNATURE:	DATE: 10/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2023

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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: LITTLE BUTTERFLIES SAN RAMON, THE	FACILITY NUMBER: 075700615
	VISIT DATE: 10/10/2023

NARRATIVE

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Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. When any IMS is provided, an updated 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 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.

Exit interview conducted and report was reviewed with the Applicant, Janani Krishnakumar.

A license for 22 school aged children operating out of 1 classroom, will be approved effective today's date, 10/10/2023.

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.

SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Melanie Otsuji
LICENSING EVALUATOR SIGNATURE:	DATE: 10/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2023

LIC809 (FAS) - (06/04)

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