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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 435700747
Report Date: 05/02/2022
Date Signed: 05/02/2022 02:25:54 PM

Document Has Been Signed on 05/02/2022 02:25 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:COMMUNITY FIRST SCHOOLFACILITY NUMBER:
435700747
ADMINISTRATOR:TRAN, THAOFACILITY TYPE:
830
ADDRESS:1171 EAST CALAVERAS BOULEVARDTELEPHONE:
(408) 739-2022
CITY:MILPITASSTATE: CAZIP CODE:
95035
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 0DATE:
05/02/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
08:40 AM
MET WITH:Thao TranTIME COMPLETED:
02:43 PM
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On 5/2/2022, a Prelicensing Visit was conducted today by Licensing Program Analyst (LPA), Melanie Otsuji. LPA met with Applicant, Thao Tran. The applicant has submitted an application for an INFANT license. A health and safety inspection was conducted inside and outside. The infant program will operate in 1 classroom. Also on site is a Preschool Component operating out of 4 classrooms. This facility is located on the back side of Victorian Square shopping plaza. Operating Monday through Friday from 7:00AM - 6:00PM. The measurements are as follows:

INDOORS: 759.77 square feet = 22 children
OUTDOORS: 3246.11 square feet = 43 children

Classrooms are equipped with varied age appropriate materials and equipment. There is a changing table within arms reach of a sink. There will be no crib aged children enrolling into the infant component as facility requested to enroll children aged 12 months to 2 years of age. There are 2 sinks located within the classroom. Office and staff bathroom will serve as isolation area for ill children. There is a total of 1 play yard for the infant aged children to utilize. Infant's will be utilizing the same play yard as the preschool aged children. Applicant is aware that children may not commingle. A yard waiver for infants and preschoolers to use the same play yard will be requested along with request, sample play scheduled shall be submitted. Building overhang and small play table with umbrella provide a shaded rest area for children. Facility will provide AM/PM snacks and lunch to children in care. Facility will utilize electronic sign in and out. The system allows for a unique identifier and records the date and time of day.
This facility plans to provide Incidental Medical Services - IMS. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Melanie Otsuji
LICENSING EVALUATOR SIGNATURE: DATE: 05/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/02/2022
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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: COMMUNITY FIRST SCHOOL
FACILITY NUMBER: 435700747
VISIT DATE: 05/02/2022
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Thao Tran a fully qualified infant/preschool director. Tran has current pediatric cpr/first aid. There is a working telephone on site. Zero Tolerance policies were explained. The center was found to be clean, safe, sanitary, and in good repair.

Applicants were reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with Applicants 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. LPA 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.

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


A license for 22 infant aged children operating out of 1 classroom will be approved on today's date, 5/2/2022.

An exit interview was conducted.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Melanie Otsuji
LICENSING EVALUATOR SIGNATURE:

DATE: 05/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/02/2022
LIC809 (FAS) - (06/04)
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