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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 430702036
Report Date: 08/17/2022
Date Signed: 08/17/2022 12:15:49 PM

Document Has Been Signed on 08/17/2022 12:15 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:CHILDREN'S HOUSE OF LOS ALTOSFACILITY NUMBER:
430702036
ADMINISTRATOR:ELLA M. MAYONFACILITY TYPE:
850
ADDRESS:770 BERRY AVENUETELEPHONE:
(650) 968-9052
CITY:LOS ALTOSSTATE: CAZIP CODE:
94024
CAPACITY: 160TOTAL ENROLLED CHILDREN: 160CENSUS: 0DATE:
08/17/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
08:47 AM
MET WITH:Ella MayonTIME COMPLETED:
12:15 PM
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A Case Management Inspection was conducted on this date 8/17/2022 by Licensing Program Analyst (LPA), Mayla Mendoza. LPA met with Board Member, Courtney Mayon. The center has applied to add a toddler-option (18 months-36 months) to their license with no increase in the number of children they are currently licensed for. The center is requesting for up to 12 toddlers in the toddler-option program. A health and safety inspection was conducted inside and outside. The preschool program consists of 5 classrooms (Classrooms 1-5) also on site are the playnasium, art studio and two play yards (the courtyard/treehouse and redwood grove). The toddler option room will be Room 2. Hours of operation are from 7:30am-6:00pm, Monday through Friday. Currently the facility is on summer break so no children were on site during today's visit. Facility also has a school age license (430710084 cap: 40) The classrooms were measured previously and remain on file.

First aid supplies are available in the center. Facility has a functioning carbon monoxide detector. Children bring snacks from home. Children can either bring their lunch from home or choose to have catered lunch. The preschool with a toddler-option program has 19 sinks and 10 toilets and 2 urinals available. There is also a separate staff bathroom. Isolation room for sick children will be the office and staff bathroom.

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.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Melanie Otsuji
LICENSING EVALUATOR SIGNATURE: DATE: 08/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/17/2022
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: CHILDREN'S HOUSE OF LOS ALTOS
FACILITY NUMBER: 430702036
VISIT DATE: 08/17/2022
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The center has obtained an approved fire clearance from the Santa Clara County Fire Department on 7/19/2022.

Mandated reporter and appeal rights, civil penalties, unusual incident reporting and fingerprint requirements were discussed today. Licensee is also being informed of the web address (www.ccld.ca.gov) for downloading child care forms, and the director is encouraged to email ChildCareAdvocatesprogram@dss.ca.gov to be included in the Child Care Quarterly Updates distribution list. The director is also reminded that mandated reporter training is required for all staff and is to be renewed every 2 years at www.mandatedreporterca.com.

There were no deficiencies cited during this visit.

A license for 160 preschoolers, which includes up to 12 toddlers in the toddler-option program will be licensed effective today 8/17/2022.

An exit interview was conducted.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Melanie Otsuji
LICENSING EVALUATOR SIGNATURE:

DATE: 08/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2022
LIC809 (FAS) - (06/04)
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