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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 274404367
Report Date: 01/15/2020
Date Signed: 01/16/2020 11:38:20 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:GONZALES UNIFIED SCHOOL DISTRICT STATE PRESCHOOLFACILITY NUMBER:
274404367
ADMINISTRATOR:NEYFY FERNANDEZFACILITY TYPE:
850
ADDRESS:550-B FIFTH STREETTELEPHONE:
(831) 675-2519
CITY:GONZALESSTATE: CAZIP CODE:
93926
CAPACITY:40CENSUS: 14DATE:
01/15/2020
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
10:45 AM
MET WITH:Neyfy FernandezTIME COMPLETED:
01:00 PM
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Licensing Program Analyst (LPA), Fermin Campos-Jaramillo made an unannounced annual random inspection to the center today. LPA observed the center is located in the grounds of the La Gloria Elementary School. LPA met with Neyfy Fernandez, Site Director, and explained the nature of today's inspection to her. LPA observed 14 children were in care today. LPA observed there were three staff members taking care of the children. LPA observed that at least one of the staff members present during the inspection have a current pediatric CPR/First Aid card. LPA observed the teacher-child ratio was in compliance with regulations. LPA observed posted the forms required by this Licensing Department.

LPA toured the facility inside and outside. Staff and children's toilets and sinks are safe and in sanitary operating conditions. LPA observed the storage areas are clean and free of litter. LPA observed disinfectants, cleaning solutions, sharp objects, and other similar items are stored inaccessible to children. LPA observed there is a first aid kit inaccessible to children. LPA observed posted a menu with the snacks and food provided by the center. Ms. Fernandez stated the center provide full meals and snacks. Ms. Fernandez stated meals are prepared in the cafeteria of the La Gloria Elementary School. LPA observed the facility has a functioning smoke detector and a fire extinguisher type 3A40BC last serviced on July 2019. LPA observed that drinking water is readily available indoor via water fountain. LPA observed there are trash cans with tight fitting covers for the disposal of solid waste. LPA observed the center has at least one working Carbon Monoxide detector.

Ms Fernandez stated that there are no weapons in the premises. The outdoor areas are surrounded with appropriate fencing and not bodies of water. LPA observed that all furniture, equipment and playground equipment is safe and in good conditions, free of sharp, loose, or pointed parts. LPA observed that shade in the playgrounds is provided by building overhang.

************************REPORT DATED 1/15/2020 CONTINUES ON PAGE #2
SUPERVISOR'S NAME: Mary SeguraTELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Fermin Campos-JaramilloTELEPHONE: 408-334-8557
LICENSING EVALUATOR SIGNATURE:

DATE: 01/15/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2020
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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: GONZALES UNIFIED SCHOOL DISTRICT STATE PRESCHOOL
FACILITY NUMBER: 274404367
VISIT DATE: 01/15/2020
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Report dated 1/15/2020 continues from page 1.
LPA observed that outdoors water is provided via water cooler and disposable cups. LPA observed there is rubber mulch as resilient materials under the climbing structure in the playground. LPA observed all floors were clean and safe.
LPA observed that a fire drill was documented on 1/14/2020 LPA reviewed a random sample of five children's files and found in them the Emergency Information form. LPA reviewed the sign-in, sign-out sheets and are signed with full signatures. LPA observed there was a medical assessment document and a preadmission health history document in each child’s record. LPA observed there are records in each personnel file documenting the educational background of the staff.

All staff have clearances through Gonzales Union School District. LPA reminded Ms Fernandez of the applicable civil penalties for those adults who have not received fingerprint clearances, are not associated to the license and who come in contact with or provide care and supervision to the children. Penalty amounts: $100.00 per person per day, minimum of $100.00 to a maximum of $500.00 per person for an initial violation and a minimum of $100.00 to a maximum of $3000.00 per person for any subsequent violations within a 12-month-period.
Ms. Fernandez stated there are not children under medication currently enrolled in the center.
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 observed that all the staff has obtain proof of completion of the mandated reporter training AB1207. LPA referred Ms. Fernandez to the Training website: www.mandatedreporterca.com for additional information on the online training. LPA observed that all the staff members present today have proof of immunization for measles, pertussis and influenza in file in compliance with the SB792.

No deficiencies were cited during today's inspection. Exit interview was conducted with Ms. Fernandez. LPA provided Ms. Fernandez with the notice of site visit which has to be visible posted for the following 30 consecutive days.
SUPERVISOR'S NAME: Mary SeguraTELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Fermin Campos-JaramilloTELEPHONE: 408-334-8557
LICENSING EVALUATOR SIGNATURE:

DATE: 01/15/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2020
LIC809 (FAS) - (06/04)
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