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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434413444
Report Date: 07/16/2021
Date Signed: 07/16/2021 03:31:03 PM

Document Has Been Signed on 07/16/2021 03:31 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:LOS ALTOS CHINESE SCHOOL CHILDREN'S CENTERFACILITY NUMBER:
434413444
ADMINISTRATOR:BAI, JIEFACILITY TYPE:
850
ADDRESS:460 SOUTH EL MONTE AVENUETELEPHONE:
(650) 935-2051
CITY:LOS ALTOSSTATE: CAZIP CODE:
94022
CAPACITY: 30TOTAL ENROLLED CHILDREN: 0CENSUS: 11DATE:
07/16/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:05 PM
MET WITH:Jie BaiTIME COMPLETED:
03:50 PM
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(1) On 7/16/2021, Licensing Program Analyst (LPA) Melanie Otsuji arrived to the facility unannounced to conduct a Required 1 Year inspection. LPA was met by Director, Jie Bai. Present during today's visit were 5 staff members and 11 preschool aged children. LPA conducted a health and safety inspection of the facility.

There are no pools, spas or other bodies of water accessible to children in care. Disinfectants and other dangerous items are kept inaccessible. Furniture and equipment were observed to be in good condition, free of sharp, loose, or pointed parts. Playground equipment was observed to be in good repair and free of hazards. Areas under high climbing equipment are cushioned with material that absorbs a fall. Toilets, hand washing stations are kept in safe and sanitary operating conditions. Food prep areas were kept clean, free of litter and rubbish. Storage containers for solid waste have tight-fitting covers that are kept on and in good repair. Drinking water was available for children inside and outside. Facility has an operable carbon monoxide detector. Fire/Evacuation Drill is documented and conducted at least once every six months with the last drill conducted on 02/19/2021.

LPA obtained the current sign in/out sheet and the number of children signed in matches current census. It also records the time of day and full legal signature of the authorized representative. Facility utilizes the staff lounge and staff bathroom for isolation should a child fall ill while in care. LPA reviewed 4 children files and 4 staff files. Children's files contained the appropriate Emergency Identification Form, and required medical assessment. Staff files contained a health screening, proof of mandated reporter and immunizations. LPA observed a menu posted showing at least one week of meals. Facility provides AM/PM snacks with lunch being brought from home.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Melanie Otsuji
LICENSING EVALUATOR SIGNATURE: DATE: 07/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/16/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
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: LOS ALTOS CHINESE SCHOOL CHILDREN'S CENTER
FACILITY NUMBER: 434413444
VISIT DATE: 07/16/2021
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Individual Medical Services (IMS) policy was discussed. When any IMS is provided, a Plan for Providing 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

There are no deficiencies cited during today's visit. The Center was provided a copy of their appeal rights (LIC 9058 01/16) and the signature on this form acknowledges receipt of these rights. This report must be available for public review for 3 years. LPA provided Notice of Site visit and staff posted visit notice in LPA presence.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Melanie Otsuji
LICENSING EVALUATOR SIGNATURE:

DATE: 07/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2021
LIC809 (FAS) - (06/04)
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