274407552-12-10-2019-07-CC-MBED-BJQVP3-20191210153604

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 274407552
Report Date: 12/10/2019
Date Signed: 12/10/2019 03:36:09 PM

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:	CREEKSIDE PRESCHOOL		FACILITY NUMBER:	274407552
ADMINISTRATOR:	MONICA CANO-RAYAS		FACILITY TYPE:	850
ADDRESS:	1770 KITTERY STREET		TELEPHONE:	(831) 753-5252
CITY:	SALINAS	STATE: CA	ZIP CODE:	93906
CAPACITY:	24	CENSUS: 19	DATE:	12/10/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	01:50 PM
MET WITH:	Lucero Carvajal		TIME COMPLETED:	03:45 PM

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Licensing Program Analyst (LPA) Mahvash Behbood conducted a Random Annual Inspection. LPA met with the Head Teacher Rocio Raeys and explained the nature of today's visit, Present also were 2 additional staff and 19 children. LPA toured the Facility both inside and outside during todays visit. LPA noted that the Facility is located on the Creekside Elementary School campus, in room 29A. LPA observed the required posted materials, including the Facility License, 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, 8:15am to 11:15 am and 12:30pm to 3:30pm.

The children and staff files are not kept on site, the Head Teacher placed a call to the District office requesting records be made available. Lucero Carvajal, Clerk arrived with the files. She also sign this licensing report. LPA reviewed four children's and the 2 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 Alisal Unified School District. Staff files contains their educational background, current CPR and First Aid certificate, immunization records and copies of Mandated Child Abuse Reporter Training.

Classroom appeared to be clean and orderly. Drinking water is readily available for the children in classroom via water container and cups and outside via water fountain. LPA observed solid waste containers with tight-fitting lids in the classroom. Staff and children's bathrooms are clean, sanitary. Director states that there are no weapons or firearms on the premises.

Report continues on next page

SUPERVISOR'S NAME: Anthony Studebaker	TELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Mahvash Behbood	TELEPHONE: (408) 334-8552
LICENSING EVALUATOR SIGNATURE:	DATE: 12/10/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/10/2019

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: CREEKSIDE PRESCHOOL	FACILITY NUMBER: 274407552
	VISIT DATE: 12/10/2019

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Meals are provided at the cafeteria provided by the district. Menu is posted

LPA observed all furniture and equipment is in good condition and safe for the children. The playground is fenced, have age appropriate climbing structure, tan bark is used for cushioning.

LPA did not observe any bodies of water.

Incidental Medical Services were discussed with the licensee. This facility provides Incidental Medical Services (IMS). However currently none of the children from AM and PM session are currently need IMS medication nor any other type of medication.

No deficiencies cited, exit interview conducted, notice of site visit and a copy of this report was left at the facility.

SUPERVISOR'S NAME: Anthony Studebaker	TELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Mahvash Behbood	TELEPHONE: (408) 334-8552
LICENSING EVALUATOR SIGNATURE:	DATE: 12/10/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/10/2019

LIC809 (FAS) - (06/04)

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