Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 430706089
Report Date: 05/10/2018
Date Signed 05/10/2018 02:43:43 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:CAMPBELL CHRISTIAN EARLY CHILDHOOD CENTERFACILITY NUMBER:
430706089
ADMINISTRATOR:KATHY HARMONFACILITY TYPE:
850
ADDRESS:1075 WEST CAMPBELL AVE.TELEPHONE:
(408) 370-4900
CITY:CAMPBELLSTATE: CAZIP CODE:
95008
CAPACITY:116CENSUS: 89DATE:
05/10/2018
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
01:46 PM
MET WITH:Kathy HarmonTIME COMPLETED:
03:00 PM
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Licensing Program Analyst (LPA) Stephanie Rangel, arrived at the facility to deliver findings on a complaint and to preform an annual random inspection on the facility's infant program (#434406701). Director, Kathy Harmon stated that she would like to be approved for the preschool to use Campbell Christian's Elementary School program's bathroom (in building 2 on the lower floor) when the preschool's bathroom is renovated during the summer (June, July and August 2018). Kathy explained that the preschool would have exclusive use of the bathrooms during the summer months. During June, July and August, the elementary school extension program would use bathrooms in another location of the school.

LPA toured the facility. The bathroom that is slated to not be in use during the summer months includes 4 sinks and 5 toilets. The bathroom that is being asked to be in use includes 3 toilets (45) 1 urinal (7) and 2 sinks (15). During the summer months if the preschool uses the elementary school bathrooms the school will still have total use of 11 toilets (165) 2 urinals (15) 8 sinks (120). Cold water is available in the children's sinks. The children will be escorted and supervised by a staff member at all times when using the bathroom.

Director to send a letter of intent to CCL by beginning of June 2018. LPA inspected the bathrooms in building 2 on the lower floor and they appear to be clean and safe for preschool children.

There are no deficiencies cited.

NOTICE OF SITE VISIT WAS ISSUED AND MUST REMAIN POSTED FOR 30 DAYS.
SUPERVISOR'S NAME: Anthony StudebakerTELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Stephanie C RangelTELEPHONE: (408) 334-8556
LICENSING EVALUATOR SIGNATURE:

DATE: 05/10/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2018
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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