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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 274404970
Report Date: 11/30/2022
Date Signed: 11/30/2022 03:48:47 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 11/30/2022 03:48 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:HENRY F. KAMMANN ELEMENTARY SCHOOLFACILITY NUMBER:
274404970
ADMINISTRATOR:JENNIFER ZANZOTFACILITY TYPE:
850
ADDRESS:521 ROCHEX AVENUETELEPHONE:
(831) 753-5665
CITY:SALINASSTATE: CAZIP CODE:
93906
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 15DATE:
11/30/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:20 PM
MET WITH:Cecilia Mora & Maria Flores Cervantes TIME COMPLETED:
03:55 PM
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Licensing Program Analyst (LPA) Elizabeth Larios conducted a unannounced Required-1 year inspection. LPA met with Teachers Cecilia Mora & Maria Flores Cervantes and explained the nature of today's visit. LPA toured the facility both inside and outside during todays visit. LPA noted that the facility is located on the Henry F. Kammann Elementary School campus, in room 49. The hours of operation are Monday - Friday, 12:00pm - 3:00pm. The program is run by the Salinas City Elementary 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.

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 bottles 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 not utilized by the children which an isolated child can use if needed. 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 a fully charged 3A40BC fire extinguisher and First Aid Kit. Facility does not have a smoke/carbon monoxide detector. Lead Teacher states that the facility does not administer medications at this time.

SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Elizabeth Larios
LICENSING EVALUATOR SIGNATURE: DATE: 11/30/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/30/2022
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: HENRY F. KAMMANN ELEMENTARY SCHOOL
FACILITY NUMBER: 274404970
VISIT DATE: 11/30/2022
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The annual inspection will be continued on a later date due to time constraint. No deficiencies cited, exit interview conducted with Lead Teacher Maria Flores Cervantes 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.
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Elizabeth Larios
LICENSING EVALUATOR SIGNATURE:

DATE: 11/30/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/30/2022
LIC809 (FAS) - (06/04)
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