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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 430703784
Report Date: 05/29/2024
Date Signed: 05/29/2024 02:35:16 PM

Document Has Been Signed on 05/29/2024 02:35 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:WEST VALLEY COLLEGE CHILD DEVELOPMENT CENTERFACILITY NUMBER:
430703784
ADMINISTRATOR/
DIRECTOR:		HORGAN, ANNEFACILITY TYPE:
850
ADDRESS:14000 FRUITVALE AVENUETELEPHONE:
(408) 741-2409
CITY:SARATOGASTATE: CAZIP CODE:
95070
CAPACITY: 92TOTAL ENROLLED CHILDREN: 36CENSUS: 26DATE:
05/29/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:40 PM
MET WITH:Anne HorganTIME VISIT/
INSPECTION COMPLETED:
02:40 PM
NARRATIVE
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Licensing Program Analyst (LPA) Samantha Yip conducted an unannounced Case Management-Incident inspection. LPA met with Master Teacher, Lisa Meyers, and Director Anne Horgan and explained the reason for the inspection. The purpose of this inspection is to review a incident that occurred on 05/16/2024 involving C-1 and supervision. Incident was self-report to the San Jose Regional Office on 05/16/2024.

During today's inspection, LPA conducted interview with staff and parent. LPA also inspected the physical plant. Based on interviews, C-1 went through both of the entrance gates and outside of the center. C-1's parent had signed the child in and was outside of the center. C-1's parent got the child after they went through the gate.

LPA discussed with Director about plans and supervision outside. Director stated that they currently have a master teacher stationed at the gate. She stated that she will conduct training with all staff as well as one on one meeting with each teacher. She also stated that they will stager tables and benches prior to the gate.

As a result of this inspection, a Type A citation was issued. Exit interview conducted and report was reviewed with Director Anne Horgan. A notice of site visit has been issued and must remain posted for 30 days.

LPA Samantha Yip informed Director Anne Horgan that this report dated 05/29/2024 documents one Type A citation which shall be posted for 30 consecutive days as there is an immediate risk to the health, safety, or personal rights of children in care.

Also, LPA Samantha informed the Director to provide a copy of this licensing report dated 05/29/2024 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Samantha Yip
LICENSING EVALUATOR SIGNATURE: DATE: 05/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/29/2024
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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Document Has Been Signed on 05/29/2024 02:35 PM - It Cannot Be Edited


Created By: Samantha Yip On 05/29/2024 at 02:13 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: WEST VALLEY COLLEGE CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 430703784

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/29/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/30/2024
Section Cited
CCR
101229(a)(1)

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Responsibility for Providing Care and Supervision. The licensee shall provide care and supervision as necessary to meet the children's needs. No child(ren) shall be left without the supervision of a teacher at any time...
This requirement is not met as evidenced by:
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By POC 05/30/2024, Director will submit written plan on supervision outside.
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Based on interview, C-1 went through both of the entrance gates and outside of the center. This poses a immediate health and safety risk to children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Joel Segura
LICENSING EVALUATOR NAME:Samantha Yip
LICENSING EVALUATOR SIGNATURE:
DATE: 05/29/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/29/2024


LIC809 (FAS) - (06/04)
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