274400223-3-16-2023-07-CC-ELAS-CPYRD2-20230316125513

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 274400223
Report Date: 03/16/2023
Date Signed: 03/16/2023 12:55:23 PM

Document Has Been Signed on 03/16/2023 12:55 PM - It Cannot Be Edited

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:	ECHO VALLEY ELEMENTARY PRESCHOOL		FACILITY NUMBER:	274400223
ADMINISTRATOR:	ELODIA LAMPKIN		FACILITY TYPE:	850
ADDRESS:	147 ECHO VALLEY ROAD		TELEPHONE:	(408) 663-2308
CITY:	PRUNEDALE	STATE: CA	ZIP CODE:	93907
CAPACITY:	20	CENSUS: 0	DATE:	03/16/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Kristina Torres		TIME COMPLETED:	01:00 PM

NARRATIVE

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Licensing Program Analyst (LPA) Elizabeth Larios conducted a unannounced Required-1 year inspection. LPA met with Preschool Program Coordinator, Kristina Torres and explained the nature of today's visit. Echo Valley Elementary Preschool office staff called Kristina Preschool Program Coordinator to inform her of inspection. LPA toured the facility both inside and outside during todays visit. LPA noted that the facility is located on the Echo Valley Elementary School campus, in portable #31. The hours of operation are Monday - Friday, 8:30am - 11:30pm. The program is run by the North Monterey County Unified School District. 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.

Per Kristina, preschool has not had any children in care since March 13, 2020. Per Kristina no children are currently enrolled and their is no staff working.

Preschool Program Coordinator Kristina Torres has a valid CPR 7/7/2024 and 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.

Kristina understands the conditions, limitations, and capacity specifications of the facility license. Kristina understands that children shall be visually supervised at all times. LPA observed classroom clean and in order. Drinking water is readily available for the children in classroom and in the outdoor playground area via water dispenser indoor and outdoor. LPA observed solid waste containers with tight-fitting lids in classroom. Kristina and children's bathrooms are clean, sanitary. Kristina states that there are no weapons or firearms on the premises. CONTINUE ON LIC 809-C

SUPERVISOR'S NAME: Joel Segura	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Elizabeth Larios	TELEPHONE: (408) 497-9236
LICENSING EVALUATOR SIGNATURE:	DATE: 03/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/16/2023

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: ECHO VALLEY ELEMENTARY PRESCHOOL	FACILITY NUMBER: 274400223
	VISIT DATE: 03/16/2023

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LPA observed all furniture and equipment is in good condition and safe for the children. The playground area utilized by children is currently being updated with a new play structure that has not been completed and fence off. 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 a fully charged 3A10BC fire extinguisher, and working smoke/carbon monoxide detectors and First Aid Kits. Kristina states that the facility does not administer 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

LPA discussed the Inactive Status option with Kristina. LPA provided Kristina with the following forms (LIC 200, LIC 999, LIC 9211, and LIC 610) to complete and submit to CCL.

No deficiencies cited, exit interview conducted with Preschool Program Coordinator, Kristina Torres and a copy of this report was provided.

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

SUPERVISOR'S NAME: Joel Segura	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Elizabeth Larios	TELEPHONE: (408) 497-9236
LICENSING EVALUATOR SIGNATURE:	DATE: 03/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/16/2023

LIC809 (FAS) - (06/04)

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