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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 430710561
Report Date: 07/24/2024
Date Signed: 07/24/2024 01:16:17 PM

Document Has Been Signed on 07/24/2024 01:16 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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:CALIFORNIA YOUNG WORLD AT ELLISFACILITY NUMBER:
430710561
ADMINISTRATOR/
DIRECTOR:		NORA LACAYOFACILITY TYPE:
840
ADDRESS:550 EAST OLIVE STREETTELEPHONE:
(408) 774-0405
CITY:SUNNYVALESTATE: CAZIP CODE:
94086
CAPACITY: 56TOTAL ENROLLED CHILDREN: 34CENSUS: 25DATE:
07/24/2024
TYPE OF VISIT:Annual/RequiredUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:20 AM
MET WITH:Nora LacayoTIME VISIT/
INSPECTION COMPLETED:
01:40 PM
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Licensing Program Analyst (LPA), Mel Matos, met with Nora Lacayo, Director, for an unannounced Annual/Required inspection. LPA notes that the Facility is located on the campus of Ellis Elementary School in Rooms D101 (D1) & D102 (D2). The Facility also has a preschool program (#434415223) which uses the same space; hours of operation: 8:30 AM to 11:30 AM Monday to Friday during the calendar school year for the Sunnyvale School District. The preschool program is closed during scheduled school breaks. The school age program operates from 6:30 AM to 8:30 AM and 12:45 PM to 5:45 PM Monday to Friday during the calendar school year. The school age program operates from 6:30 AM to 5:45 PM during school breaks. The preschool and school age programs have exclusive use of Rooms D101 (D1) & D102 (D2) when either program is in session.

LPA observed the required posted materials, including the Facility License, Emergency Disaster Plan (LIC 610), Earthquake Preparedness Checklist (LIC 9148), Parents' Rights Poster (PUB 393), Personal Rights (LIC 613A), Child Car Seat Law (PUB 269), Menus, and Activity Schedule.

LPA three staff (1 director, 1 teacher, and 1 aide) and five children's files during today's inspection. Each child's file reviewed contains the Information and Emergency Information form (LIC 700). All staff files reviewed contain the required transcripts/verification of experience/immunization records, and Health Screening Report. All staff have current certificates of completion of the Mandated Reporter Training for Child Care Workers on file. Nora and one teacher in the Facility has current CPR and First Aid certifications on file. Nora understands that there shall be at least one person, with valid CPR and First Aid certifications, on site at all times or present during off-site activities (field trips). Last fire/disaster drill was completed on June 7, 2024.

LPA notes that the Facility is Title 5 funded and thus Title 5 ratios apply. LPA observed that the teacher/child ratio was in compliance during today's inspection. LPA observed 25 children with the director, one teacher, and one aide in Rooms D101 (D1) and D102 (D2). Nora understands the conditions, limitations, and capacity specifications of the Facility license. Nora understands that children shall be visually supervised at all times within the classroom and in the playground areas. Any child(ren) who exhibit symptoms of illness including, but not limited to, fever or vomiting, are not accepted in care. Any child(ren) who become ill during the day, shall be isolated in the director's office area in Room D101 (D1).

LPA observed that the Facility is clean, safe, sanitary, and in good repair for children, staff, and visitors. The Facility has central heating and air conditioning in both Rooms. Nora states that the Facility has a third-party cleaning service that cleans the Facility Monday through Friday in the evenings. Drinking water is readily available for the children in each Room and in the outdoor playground area via reusable water bottles and water dispensers.
SUPERVISORS NAME: Belinda Devall
LICENSING EVALUATOR NAME: Melvin S Matos
LICENSING EVALUATOR SIGNATURE: DATE: 07/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/24/2024
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: CALIFORNIA YOUNG WORLD AT ELLIS
FACILITY NUMBER: 430710561
VISIT DATE: 07/24/2024
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Staff and children's bathrooms are clean, sanitary, and operable. Children's bathroom allows for individual privacy for the children. There is a separate staff bathroom in Room D101 (D1) not utilized by the children which an isolated child can use if needed. Nora states that there are no weapons or firearms on the premises. The Facility has functioning carbon monoxide detectors in each Room. Cleaning supplies are inaccessible to the children and stored in high cabinets inside each classroom. LPA observed solid waste containers with tight-fitting lids in each Room. Nora understands that smoking is not allowed on the premises. Nora states that the Facility does not administer any medication at this time.

The Facility uses disposable plates & utensils to serve breakfast, AM/PM snacks, and lunch to the children. There is a kitchen area in Room D101 (D1) with hot/cold water sink, toaster oven, microwave, and toaster for food preparation. The food preparation and storage areas are clean, free of litter & rubbish, and free of rodents and other vermin. All food and beverages that require refrigeration are stored in covered containers at 45 degrees F or less.

LPA observed all furniture and equipment is in good condition and safe for the children. The playground area utilized by preschool children is surrounded by appropriate fencing. The outdoor surfaces are safe for the children. Shade is provided by a canopy, trees, and building overhangs in the playground area. LPA observed that the outdoor equipment is age appropriate and in good condition. There is a play structure that is age appropriate for the children. The play structure is safe, secure, and has artificial grass with rubber padding as resilient materials surrounding and underneath the play structure. LPA did not observe any bodies of water. The school age program has exclusive use of the playground areas whenever the school age children are present.

Nora Lacayo, Director, was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated. All criminal record background checks are associated to the preschool license (#430703885).

Nora Lacayo, Director, was informed of the MyChildCarePlan.org website; 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.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.
Exit interview conducted and report was reviewed with Nora Lacayo, Director, and advised her that no deficiencies issued during today's inspection. A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Belinda Devall
LICENSING EVALUATOR NAME: Melvin S Matos
LICENSING EVALUATOR SIGNATURE:

DATE: 07/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/24/2024
LIC809 (FAS) - (06/04)
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