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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 430710595
Report Date: 12/15/2023
Date Signed: 12/18/2023 08:06:25 AM

Document Has Been Signed on 12/18/2023 08:06 AM - 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:GROWING FOOTPRINTS & GROWING FOOTSTEPS-LOS GATOSFACILITY NUMBER:
430710595
ADMINISTRATOR:NEWTON, JAMIEFACILITY TYPE:
850
ADDRESS:16575 SHANNON ROADTELEPHONE:
(408) 356-4442
CITY:LOS GATOSSTATE: CAZIP CODE:
95032
CAPACITY: 84TOTAL ENROLLED CHILDREN: 84CENSUS: 8DATE:
12/15/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
03:28 PM
MET WITH:Vanessa Chavira-ManriqueTIME COMPLETED:
04:00 PM
NARRATIVE
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Licensing Program Analysts (LPAs) Samantha Yip and Jessica Bongardt conducted an unannounced Case Management- Other inspection. LPA met with Assistant Director Vanessa Chavira-Manrique and explained the reason for the inspection. The purpose of this inspection is to discuss supervision.

At 3:36PM, LPAs observed that children were outside. LPAs observed that one staff was at the sandbox and one staff was on the field. There was one child that was behind the slide on the play structure. Staff cannot visually see the child from where they were. At 3:56PM, LPA observed that a staff went over the child.

LPA discussed with Assistant Director Vanessa that children need to be supervised at all time including visually.

As a result of this inspection, a Type B citation was issued. Exit interview was conducted and report was reviewed Assistant Director Vanessa Chavira-Manrique. A notice of site visit has been issued and must remain posted for 30 days.
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Samantha Yip
LICENSING EVALUATOR SIGNATURE: DATE: 12/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/15/2023
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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Document Has Been Signed on 12/18/2023 08:06 AM - It Cannot Be Edited


Created By: Samantha Yip On 12/15/2023 at 04:17 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: GROWING FOOTPRINTS & GROWING FOOTSTEPS-LOS GATOS
FACILITY NUMBER: 430710595

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/15/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/22/2023
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... Supervision shall include visual observation.
This requirement was not met as evidenced by:
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By 12/22/2023, center will submit written plan outlining how they will ensure that children are supervised at all times, including visually.
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Based on observation, LPAs observed that a child was behind the slide of the play structure. A staff did went over to the child. There were two staff present, but cannot visually see the child from where they were positioned. This poses a potential health and safety risk to children.
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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: 12/15/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/15/2023


LIC809 (FAS) - (06/04)
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