013419400-11-29-2021-52-CC-KPHN-C98QPS-20211129112114

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013419400
Report Date: 11/29/2021
Date Signed: 11/29/2021 11:21:22 AM

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:	SUNOL GLEN PRESCHOOL		FACILITY NUMBER:	013419400
ADMINISTRATOR:	COLLIER, KIRSTEN		FACILITY TYPE:	850
ADDRESS:	11601 MAIN ST.		TELEPHONE:	(925) 580-9306
CITY:	SUNOL	STATE: CA	ZIP CODE:	94586
CAPACITY:	24	CENSUS: 10	DATE:	11/29/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Kirsten Collier Kotsakis		TIME COMPLETED:	11:35 AM

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 11/29/2021 at 9:00am, Licensing Program Analysts (LPA) Kelly Phan and Licensing Program Manager (LPM) Jason Jang met with Kirsten Collier- Kotsakis (Preschool Director) for an unannounced required 1 year inspection. Present for this inspection are 10 preschool aged children and a fingerprinted and associated teacher, Cathy Cornell. Facility operating hours are 8:30am-3pm Monday -Friday. The facility was toured to conduct a health and safety inspection. At 9:20am, LPA and LPM toured the facility classroom. The facility operates in a classroom #201 on the site of Sunol Glen Elementary School. The isolation area is located inside Sunol Glen Elementary school in the staff room. The classroom is tidy and clean with heating and ventilation for safety and comfort. There are safe age-appropriate toys and learning materials available to children throughout the classroom. There were no hazardous materials and toxins present during today's inspection. Furniture accessible to children was observed to be age-appropriate, in operable condition, and free of loose, sharp, or pointed parts. Per Kirsten (preschool director), all children bring their own snacks and lunches and store them in their lunch boxes that has ice pack. Safe drinking water is available to children inside and outside the facility. LPA and LPM also toured the facility bathrooms. There were adequate amounts of paper towels and hand soap available to children in the bathroom, there were no cleaning supplies were observed to be accessible to children. LPA reviewed sign in/sign out binder. There were 10 signatures out of 10 children present in the facility during today's inspection. There is a fully charged 2A10BC fire extinguisher, working telephone; carbon monoxide and smoke detectors are inspected by Fire Marshall every year per Kirsten (preschool director). At 9:40am, The playground was observed to be operable and age-appropriate during this inspection. The playground is shared with other students of Sunol Glen Elementary School. Areas around swings, slides, and high climbing equipment have cushioning material to absorb falls. There are no pools, hot tubs, ponds, or any other bodies of water accessible to children during today's inspection. SEE LIC 809 C .

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 622-2631
LICENSING EVALUATOR NAME: Kelly Phan	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 11/29/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/29/2021

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: SUNOL GLEN PRESCHOOL	FACILITY NUMBER: 013419400
	VISIT DATE: 11/29/2021

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At 10:05am, six children's files and 2 staff files were reviewed and found to be complete. All required forms are posted in public view. Facility roster was reviewed and a copy was obtained. This facility does not provide any medical services to the children.

Facility Representative 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.

Facility Representative was reminded that California Law requires licensed Child Care Centers to report unusual incidents or injuries to children in care to child's parents and to the Department of Social Services using the Unusual Incident/Injury form (LIC 624). Incidents must be reported within 24 hours by phone, fax, or electronic mail. LPA informed the Facility Representative that all forms can be downloaded at www.ccld.ca.gov and encouraged the Facility Representative to email childcareadvocatesprogram@dss.ca.gov to be included in the Child Care Quarterly Updates distribution list. The Facility Representative was also reminded that Mandated Reporter Training ("General" and "Child Care Providers") is required for all staff and is to be renewed every 2 years by visiting www.mandatedreporterca.com.

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 622-2631
LICENSING EVALUATOR NAME: Kelly Phan	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 11/29/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/29/2021

LIC809 (FAS) - (06/04)

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