Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434414640
Report Date: 04/27/2016
Date Signed 04/29/2016 12:35:30 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:CENTRO ARMONIA SPANISH SCHOOL-SANTA TERESAFACILITY NUMBER:
434414640
ADMINISTRATOR:CLAUDIA & PATRICIAFACILITY TYPE:
830
ADDRESS:196 MARTINVALE LANETELEPHONE:
(408) 833-5290
CITY:SAN JOSESTATE: CAZIP CODE:
95119
CAPACITY:16CENSUS: 0DATE:
04/27/2016
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Patricia Martin and Claudia HernandezTIME COMPLETED:
01:15 PM
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This is an amended report. The original report for the Preschool Facility #434414641 was accidentally written on the infant facility #434414640. The capacity on the report should be 8 not 16. Applicants submitted an LIC200A application to decrease the capacity.

Licensing Program Analyst's (LPA's) Pam Burkett and Stephanie Rangel met with Applicant's, Patricia Martin and Claudia Hernandez. Site Director Mayra Nugyen was also present LPA's toured the facility both inside and outside, as well as measured the space for children. Infant indoor measurements are:

INFANT ROOM 31.667 X 11.417 = 361.542
minus 14.750 X 2.083 = 30.724 (encumbered space)
TOTAL INDOOR PRESCHOOL SPACE: 330.818 SQ. FT. DIVIDED BY 35 = 9 CHILDREN.
Outdoor measurements:
176.498 x 26.747 = 4,720.792
33.249 x 42.166 = 1,401.977
1/2 (19.249)(28.747) = 276.676
1/2 (65.83)(53.498) = 1,760.887
65.83 x 15.498 = 1,020.233
24.664 x 11.664 = 287.681
minus 42.624(encumbered space)
minus 31.968 (encumbered space)

TOTAL INFANT OUTDOOR SPACE: 9393.654 sq ft divided by 75 = 125 children.

[Facility Evaluation Report dated 04/27/16 is continued on the following page]:
SUPERVISOR'S NAME: Sandy KnightTELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Pam BurkettTELEPHONE: (408) 324-2111
LICENSING EVALUATOR SIGNATURE:

DATE: 04/27/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/27/2016
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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: CENTRO ARMONIA SPANISH SCHOOL-SANTA TERESA
FACILITY NUMBER: 434414640
VISIT DATE: 04/27/2016
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FIRE CLEARANCE WAS GRANTED AND APPROVED ON April 18, 2016. The facility has a carbon monoxide detector.

Site Director, Mayra Nguyen is missing one unit of administration. LPA will process and grant an exception for the one unit. Myra must enroll and complete the unit by December 2016. Proof of completion must be submitted to CCL.

LICENSE IS GRANTED EFFECTIVE TODAY FOR CAPACITY OF 8 INFANTS.
SUPERVISOR'S NAME: Sandy KnightTELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Pam BurkettTELEPHONE: (408) 324-2111
LICENSING EVALUATOR SIGNATURE:

DATE: 04/27/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/27/2016
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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: CENTRO ARMONIA SPANISH SCHOOL-SANTA TERESA
FACILITY NUMBER: 434414640
VISIT DATE: 04/27/2016
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There is 2 sinks (30) available for the children. LPA's observed an appropriate diaper changing table in the room which is within arms reach of a sink. Staff have a separate bathroom. The sick child will be isolated in a portable crib in the office. Parents will provide all food the infants. Parents will be providing bottles. Sanitation will be completed by the 3 step hand washing process. There are trash cans with tight-fitting lids located throughout the facility. The room has appropriate lighting. Medication is stored in a locked box located in the teachers work room. First aid supplies are stored in the teachers work room and there is also first aid supplies in a back pack in the hallway by the office. Cleaning supplies are stored in locked janitor's closet. There will be a janitorial service that will be cleaning every night Monday through Friday. There are 8 cubbies, 1 table, 4 small chairs, 2 high chairs, and 8 cribs.

Infants who are unable to sit up on their own will be held while fed. The crib area is separated from the activity area with a solid 4 feet 3 inches high wall. Applicant understands that the infants must be under direct visual supervision at all times. There is adequate equipment, supplies and toys for children. Drinking water will be provided by the children's individual cups/bottles. The phone number on site is (408) 609-3383.

The preschool, toddler, and infant program all use the playgrounds. There has been a schedule submitted showing separate times when he play ground is being used by each age group. None of the age groups will be commingling. The yards are surrounded by appropriate fencing. Shade is provided by several trees. There is adequate resilient material. There are no play structures on the playgrounds. There is sufficient play equipment for use on the playgrounds. Drinking water will be provided by water containers and cups both indoor and outdoor. No transportation is provided by the center. Photos of the indoor and outdoor space were taken.

Applicants were advised on the requirements of AB 633, car seat law, immunization's needed before enrolling in the infant program, and healthy beverages in child care. Incidental Medical Services were discussed with the applicants. The applicants are providing IMS (Incidental Medical Services) at this time. Applicants have submitted a plan that includes incidental medical services.
SUPERVISOR'S NAME: Sandy KnightTELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Pam BurkettTELEPHONE: (408) 324-2111
LICENSING EVALUATOR SIGNATURE:

DATE: 04/27/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/27/2016
LIC809 (FAS) - (06/04)
Page: 2 of 3