<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434417190
Report Date: 08/28/2024
Date Signed: 08/28/2024 11:02:18 AM

Document Has Been Signed on 08/28/2024 11:02 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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:CASA DI MIR MONTESSORI ELEMENTARY SCHOOLFACILITY NUMBER:
434417190
ADMINISTRATOR/
DIRECTOR:		TYLER BOURCIERFACILITY TYPE:
860
ADDRESS:1975 CAMBRIANNA DRIVETELEPHONE:
(408) 370-3073
CITY:SAN JOSESTATE: CAZIP CODE:
95124
CAPACITY: 60TOTAL ENROLLED CHILDREN: 60CENSUS: 0DATE:
08/28/2024
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Joy Yap TIME VISIT/
INSPECTION COMPLETED:
11:40 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 08/28/24, Licensing Program Analysts (LPAs) Harsimran Kaur and Liridon Fici met with Joy Yap, Applicant Representative. The purpose of the visit was an announced pre-licensing inspection at the facility to ensure the health, safety and personal rights as required by Title 22 and Health and Safety Regulations governing California Child Care Centers will be met. The facility has an existing preschool program Facility#434404307. Applicants requested for a change of location and capacity increase of preschool license with capacity of 60 preschool children ages 3 to 6 years in Poppy, sunflower and Iris room. The child care center will operate from Monday–Friday 8:00 AM to 6:00 PM. Fire clearance was approved on 08/23//2024.

LPAs toured and measured the on-limits areas and classrooms located at the facility. The facility has a total of 3 classrooms.

Preschool Classrooms measurements are:

The Indoor total measurements contain a total of {2831.32} square feet, which will accommodate Applicant's request for 60 preschool children.

Preschool Outdoor Play measurements are:

Outdoor total measurements contain a total of {7335.01) square feet, which will accommodate Applicant’s request for 60 preschool children.

Indoor/Children's Area


All indoor and outdoor activity space utilized for the children was inspected today. LPAs informed Applicant that staff are required to maintain direct visual supervision of the children at all times during indoor and outdoor activities. The classrooms are observed to be clean, safe, sanitary and in good repair. All outdoor and indoor passage ways and other areas of potential hazard were free of obstruction. A comfortable temperature for children shall be maintained at all times. Furniture and equipment were observed to be maintained in good condition, free of sharp, loose or pointed parts. All materials and surfaces accessible to children, including toys, shall be free of toxic substances. All play equipment and materials used by children were observed to be age-appropriate. Tables and chairs were observed to meet the needs of the children. There are 72 chairs, 30 tables, 5 sinks, 58 cubbies, 3 toilets, 35 cots and 1 urinal available for preschool children.
SUPERVISORS NAME: Deborah Lowe
LICENSING EVALUATOR NAME: Harsimran Kaur
LICENSING EVALUATOR SIGNATURE: DATE: 08/28/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/28/2024
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 3
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: CASA DI MIR MONTESSORI ELEMENTARY SCHOOL
FACILITY NUMBER: 434417190
VISIT DATE: 08/28/2024
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
The Applicant shall take measures to keep the center free of flies, other insects, and rodents. All containers used for storage of solid wastes, including moveable bins, shall have a tight fitting cover that is kept on. LPAs observed no fireplace or open face heaters. Lunch and snacks provided by parents. Facility will also provide snacks if kids forget their snacks at home.

Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to children shall be stored where inaccessible to children. Drinking water is readily available for the children in the facility via filtered water and water bottles.

There is a fully equipped first aid kit available. There is an operational carbon monoxide detector on site. A separate staff bathroom is available. Applicant stated that any child who becomes ill during the day shall be isolated in office area.

Outdoor:

LPAs observed the facility has a fully fenced outdoor playground for preschool children. Outdoor areas were free of hazards including, holes, broken glass dry grasses, and other debris that pose a fire hazard. Any construction or equipment that could pose a hazard in the outdoor activity areas shall be made inaccessible to children in care. Shade was provided by canopies and wood shed. The playground is enclosed by a fencing at least 6 feet high. There are sufficient outdoor age-appropriate toys and play equipment available on the playground. There is adequate cushioning in fall zones provided by tanbark. LPAs observed no bodies of water.


Drinking water from a non-contaminating fixture or container shall be readily available both indoors and in the outdoor activity area. LPAs advised per Health and Safety Code 1597.16(a)(1) Lead Testing and PIN-21-21-CCP Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010 to test their drinking water for lead contamination between January 1, 2020 and January 1, 2023, and then every 5 years after the date of the first test.

SUPERVISORS NAME: Deborah Lowe
LICENSING EVALUATOR NAME: Harsimran Kaur
LICENSING EVALUATOR SIGNATURE:

DATE: 08/28/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2024
LIC809 (FAS) - (06/04)
Page: 2 of 3
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: CASA DI MIR MONTESSORI ELEMENTARY SCHOOL
FACILITY NUMBER: 434417190
VISIT DATE: 08/28/2024
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Per Written Directive 100700(c)(1) Written Directives for Lead Testing (1) For a license issued on or after July 1, 2022, initial testing results shall be received and posted within 180 days of licensure.


This facility plans to provide Incidental Medical Services – IMS. For IMS information, see PIN 22-02-CCP. 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) or (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.

LPAs discussed the safe sleep regulations with Director and discussed the Child Care Licensing Safe Sleep webpage at: https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep, as
an additional resource. LPAs also informed Applicants of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at: https://www.cpsc.gov/, and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

LPAs reviewed with the Applicants LIC 311A, Records to Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted.

Applicants were informed of the MyChildCarePlan.org site, 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.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.


An exit interview was conducted and copy of appeal rights were provided to Joy yap, Applicant Representative. Final license determination for a single license will be made upon review by the Licensing Program Manager.
SUPERVISORS NAME: Deborah Lowe
LICENSING EVALUATOR NAME: Harsimran Kaur
LICENSING EVALUATOR SIGNATURE:

DATE: 08/28/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2024
LIC809 (FAS) - (06/04)
Page: 3 of 3