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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 435700748
Report Date: 05/02/2022
Date Signed: 05/02/2022 02:24:31 PM

Document Has Been Signed on 05/02/2022 02:24 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:
435700748
ADMINISTRATOR:TRAN, THAOFACILITY TYPE:
850
ADDRESS:1171 EAST CALAVERAS BOULEVARDTELEPHONE:
(408) 739-2022
CITY:MILPITASSTATE: CAZIP CODE:
95035
CAPACITY: 73TOTAL ENROLLED CHILDREN: 73CENSUS: 0DATE:
05/02/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
08:41 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 a PRESCHOOL license. A health and safety inspection was conducted inside and outside. The preschool program will operate in 4 classrooms. Also on site is an Infant Component operating out of 1 classroom. Facility resides on the back side of Victorian Square shopping plaza. Operating hours Monday through Friday from 7:00AM - 6:00PM. The measurements are as follows:

INDOORS: 2783.01 square feet = 80 children
OUTDOORS: 3246.11 square feet = 43 children

Measurements were taken of each room and of the out door play yard. There is a separate staff bathroom and it will be utilized for an isolation restroom if a child becomes ill. There is a fully stocked first aid kit with all required equipment available and a box for stored medications. No exit doors were blocked. There is ample toys and furnishings throughout the center for children's use. There are cots available for children.
There are 8 toilets (sized appropriately) and 8 sinks available for children's use. Heating and lighting was adequate. There is ample play space for the children. There is 1 play yard for the preschool aged children. And areas under high climbing equipment have material that can absorb a fall. Yard will be shared with infant component. Yard waiver on file. The center Director will be Thao Tran and a directors packet with all required documentation was submitted to CCL to complete the application. Facility will provide lunch and AM/PM snacks and lunch to the children.
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: 435700748
VISIT DATE: 05/02/2022
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There are no bodies of water nor hazards found on the premises. Playground equipment is in good condition. Drinking water is available inside and outside. All toilets and hand washing facilities are in safe and sanitary operating conditions. All licensing required documents are posted. 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

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 73 preschoolers operating out of 4 classrooms will be approved effective 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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