073408250-8-10-2021-02-CC-MGUT-C5RUKR-20210810153936

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 073408250
Report Date: 08/10/2021
Date Signed: 08/10/2021 03:40:22 PM

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, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME:	GOOD EARTH SCHOOL, THE		FACILITY NUMBER:	073408250
ADMINISTRATOR:	GAIL PAVLOSKY		FACILITY TYPE:	850
ADDRESS:	1 LAWSON ROAD		TELEPHONE:	(909) 816-8919
CITY:	KENSINGTON	STATE: CA	ZIP CODE:	94707
CAPACITY:	74	CENSUS: 0	DATE:	08/10/2021
TYPE OF VISIT:	Case Management - Licensee Initiated	ANNOUNCED	TIME BEGAN:	12:00 PM
MET WITH:	Gail Pavlosky and Alan Pavlosky		TIME COMPLETED:	04:00 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 08/10/21 at 12:00 pm, Licensing Program Analysts (LPAs) Melissa Guirit and Melissa Domantay arrived at the facility for an announced case management inspection. LPA met with licensees Gail and Alan Pavlosky. There were no children present during today's inspection. The facility is on the grounds of the Unitarian Universalist Church of Berkeley. The normal hours of operation are Monday-Friday 7:45am-5:30pm. An application was received to add eight additional rooms (one room becoming the staff lounge), four additional bathrooms, and three additional outdoor play spaces with an increase of capacity. There are no changes to the bathrooms and outdoor space that were previously licensed. LPAs toured the new spaces to conduct a health and safety inspection, and completed the following measurements: INDOORS: 4286.69 = 122 children OUTDOORS: 17470.27 = 232 children All other indoor and outdoor measurements remain the same. Per licensee, the 5th classroom that was previously measured will not be in use no longer and has been taken off the measurements. A fire clearance was received from the El Cerrito Fire Department on 07/28/21. The new outdoor play yards are completely fenced and have ample supply of age appropriate toys and equipment. LPAs observed that there is sufficient heating, lighting and ventilation in the classrooms, and the classroom floors and surfaces are clean and free of hazards. The rooms have an ample supply of age appropriate furniture, toys and equipment which appear to be in good condition. See 809-C for continuance.

SUPERVISOR'S NAME: Loretta Dyson	TELEPHONE: (510) 695-0243
LICENSING EVALUATOR NAME: Melissa Guirit	TELEPHONE: (510) 566-8898
LICENSING EVALUATOR SIGNATURE:	DATE: 08/10/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/10/2021

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 2

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, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: GOOD EARTH SCHOOL, THE	FACILITY NUMBER: 073408250
	VISIT DATE: 08/10/2021

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
26
27
28
29
30
31
32

There are a total of eight toilets and nine sinks. LPAs did not observe any bodies of water, hazardous items or toxins that would be accessible to children. LPAs observed operating sinks and covered waste cans. The rooms are equipped with fully charged 3A40BC fire extinguishers, carbon monoxide detectors and centralized smoke detection systems. The facility has a working telephone and first aid supplies.

The new spaces which include the seven rooms, four bathrooms, and three outdoor play spaces, and license for a capacity of 120 children will be made part of the license, effective today 08/10/21, and can be used when the facility is ready. There are no deficiencies being cited today. This report will remain on file for 3 years. A Notice of Site inspection was provided to the licensees, and an exit interview was conducted.

SUPERVISOR'S NAME: Loretta Dyson	TELEPHONE: (510) 695-0243
LICENSING EVALUATOR NAME: Melissa Guirit	TELEPHONE: (510) 566-8898
LICENSING EVALUATOR SIGNATURE:	DATE: 08/10/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/10/2021

LIC809 (FAS) - (06/04)

Page: 2 of 2