435700748-3-21-2023-52-CC-MESA-CQ5V42-20230321160537

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 435700748
Report Date: 03/21/2023
Date Signed: 03/21/2023 04:05:50 PM

Document Has Been Signed on 03/21/2023 04:05 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 SCHOOL		FACILITY NUMBER:	435700748
ADMINISTRATOR:	TRAN, THAO		FACILITY TYPE:	850
ADDRESS:	1171 EAST CALAVERAS BOULEVARD		TELEPHONE:	(408) 739-2022
CITY:	MILPITAS	STATE: CA	ZIP CODE:	95035
CAPACITY: 73	TOTAL ENROLLED CHILDREN: 73	CENSUS: 8	DATE:	03/21/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:19 AM
MET WITH:	Thao Tran		TIME COMPLETED:	04:30 PM

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 Tuesday, March 21, 2023 10:19 am, Licensing Program Analyst (LPA) Manel Estoesta conducted an Unannounced Required One (1) Year Visit. LPA met with the Director Thao Tran and explained the nature of the site visit. Present on this visit were 8 preschool children and 3 staff members. Facility operates from Monday through Friday from 8:00AM - 6:00PM. This facility is located on the back side of Victorian Square shopping plaza. The facility is a COMBINATION CENTER FOR AN INFANT COMPONENET on site. The facility has shared office space, food-preparation space, storage space and any other general-purpose space. The facility has an Outdoor Play Yard Waiver. LPA observed the Waiver Document posted at 10:30 am. LPA toured the facility to conduct a health and safety inspection with the Director. The childcare center is clean, safe, sanitary and in good repair. Room number One (1) to Four (4) are the Licensed Room. Currently, the only active room is Room number Three (3). Restrooms for children to use in each room were observed to be in safe and sanitary operating conditions. There were no bodies of water observed. Director stated that facility do not have weapons on the premises. Furniture and equipment were in good condition, free of sharp, loose, or pointed parts. The facility prepares and provides Lunch and AM/PM snacks for the children. LPA observed and reviewed the Menus. The kitchen, food-preparation and storage areas were observed in clean and free of litter and rubbish and the facility have measures taken to keep all such areas free of rodents and other vermin. Floors were clean and safe, and outdoor activity space were free of hazards. Disinfectants, cleaning solutions, poisons, and other items that are dangerous to children were stored inaccessible to children. SEE 809 C

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Manel Estoesta
LICENSING EVALUATOR SIGNATURE:	DATE: 03/21/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2023

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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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: 03/21/2023

NARRATIVE

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Continuation.

LPA observed a fire extinguisher, Emergency Bag that has a First Aid Kit, Fire Pull Alarms, Fire Sprinklers, smoke and carbon monoxide detectors. Outdoor activity space is fenced and play equipment were maintained in a safe condition and free of hazards. There were shaded rest areas for children. Drinking water is arranged to be readily available for children in care.

At noon, LPA reviewed the following;
1. Fire Drill was last conducted on 01/23/2023.
2. Earthquake Drill was last conducted on 10/22/2022.
3. Paper Sign In and Out Sheets (children).
4. Facility files were reviewed. Child sign in and out procedures, LPA also obtained copies of the Facility's updated Personnel Report and Child Care Facility Roster.
5. Staff files were reviewed.
6. Children Files were reviewed. Each child’s file contains but not limited to , which included records of receipt for Parents' Rights Notice, Identification and Emergency Information, Consent for Emergency Medical Treatment form, Risks and Effects of Lead Poisoning PUB 515, Child Incident Report and Immunization.
7. Daily Activity Schedule.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. 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

LPA discussed the American Rescue Plan Act Survey, Child Care and Development Infrastructure Grant Program and LIC 311A (2/22) RECORDS TO BE MAINTAINED AT THE FACILITY with the Director.

SEE 809 C.

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Manel Estoesta
LICENSING EVALUATOR SIGNATURE:	DATE: 03/21/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2023

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: 03/21/2023

NARRATIVE

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Continuation.

Director was reminded that all adults 18 and over, 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.

For licensing updates, please email childcareadvocatesprogram@dss.ca.gov and request to be added to the email list. Previous Provider Information Notices (PINs) - Child Care Licensing Program (CCLP) are available at the CCLD website and other helpful information at https://cdss.ca.gov/inforesources/child-care-licensing.

A notice of site visit was given and must remain posted for 30 days.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

There are no deficiencies cited on this visit.

Exit interview conducted and report was reviewed with the Director, Thao Tran.

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Manel Estoesta
LICENSING EVALUATOR SIGNATURE:	DATE: 03/21/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2023

LIC809 (FAS) - (06/04)

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