270710326-8-14-2019-07-CC-JMAS-BF2P58-20190814110019

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 270710326
Report Date: 08/14/2019
Date Signed: 08/14/2019 11:00:25 AM

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:	APPLE PIE SCHOOL		FACILITY NUMBER:	270710326
ADMINISTRATOR:	VICKI BRIESACKER		FACILITY TYPE:	850
ADDRESS:	CA 1 AT CAPTAIN COOPER SCHOOL		TELEPHONE:	(831) 667-2921
CITY:	BIG SUR	STATE: CA	ZIP CODE:	93920
CAPACITY:	20	CENSUS: 9	DATE:	08/14/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	08:40 AM
MET WITH:	Margaret Lopez		TIME COMPLETED:	11:10 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

Licensing Program Analyst (LPA) Joe Macias conducted a Random Annual Inspection. The purpose of today’s inspection is to ensure the facility is in compliance with Title 22 California Code of Regulations. LPA met with the Head Teacher Margaret Lopez, and explained the nature of today's visit. LPA toured the Facility both inside and outside during todays visit. LPA noted the center is located on the Captain Cooper Elementary School campus. LPA observed the required posted materials, including the Facility License, Emergency Disaster Plan (LIC 610), Earthquake Preparedness Checklist (LIC 9148), Parents' Rights Poster (PUB 393), Personal Rights (LIC 613A), Child Car Seat Law (PUB 269), and Activity Schedule. The hours of operation are Monday - Friday, 8:30am - 4pm.

LPA reviewed children's and staff files during today's visit. Each child's file reviewed contains the Information and Emergency Information form (LIC 700), immunization records, physicians report, personal rights, and parents rights. The Site Directors file contain the required transcripts/verification of experience. All staff have clearances through Carmel Unified School District. Director and staff have current CPR and First Aid certifications on file. The Director understands that there shall be at least one person with valid CPR and First Aid certifications on site at all times, or present during off-site activities (field trips).

Director understands the conditions, limitations, and capacity specifications of the Facility license. Director understands that children shall be visually supervised at all times. LPA observed that all rooms are clean and in order. Drinking water is readily available for the children in each room and in the outdoor playground area via water fountain, water dispensers and cups. LPA observed solid waste containers with tight-fitting lids in each room. Staff and children's bathrooms are clean, sanitary. There is a separate staff bathroom in the school office, not utilized by the children which an isolated child can use if needed. Director states that there are no weapons or firearms on the premises.

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Joseph Macias	TELEPHONE: (408) 334-8320
LICENSING EVALUATOR SIGNATURE:	DATE: 08/14/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/14/2019

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 3

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: APPLE PIE SCHOOL	FACILITY NUMBER: 270710326
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/14/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 08/16/2019 Section Cited CCR 101238(a)	1 2 3 4 5 6 7	Buildings and Grounds: The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors.	1 2 3 4 5 6 7	The Director shall ensure a fire extinguisher is installed and maintained in the classroom. The Director shall submit proof of correction, along with a letter of understanding by the POC date.
	8 9 10 11 12 13 14	LPA observed missing fire extinguisher in the classroom. This poses a potential risk to the health, saftey, and personal rights of children in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Joseph Macias	TELEPHONE: (408) 334-8320
LICENSING EVALUATOR SIGNATURE:	DATE: 08/14/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/14/2019

LIC809 (FAS) - (06/04)

Page: 3 of 3

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: APPLE PIE SCHOOL	FACILITY NUMBER: 270710326
	VISIT DATE: 08/14/2019

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

LPA observed all furniture and equipment is in good condition and safe for the children. The playground area utilized by children is surrounded by appropriate fencing and the outdoor surfaces are safe for the children. LPA observed that the outdoor equipment is age appropriate. LPA did not observe any bodies of water.

The food preparation and storage areas are clean, free of litter & rubbish, and free of rodents and other vermin. Cleaning supplies are securely stored and inaccessible to the children. LPA observed missing fire extinguisher in the classroom. LPA observed working smoke/carbon monoxide detectors. Director states that the Facility does not administer any medications at this time.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. 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

All staff have completed the Mandated Reporter Training.

LPA advised the Director of the new immunization requirement (pertussis, measles, and flu vaccines) for all staff and volunteers that work directly with the children.

Type B deficiency cited, exit interview conducted, and a copy of this report was left at the facility.

A NOTICE OF SITE VISIT WAS ISSUED, POSTED NEAR THE ENTRANCE TO THE FACILITY, AND MUST REMAIN POSTED FOR 30 DAYS.

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Joseph Macias	TELEPHONE: (408) 334-8320
LICENSING EVALUATOR SIGNATURE:	DATE: 08/14/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/14/2019

LIC809 (FAS) - (06/04)

Page: 2 of 3