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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 274408742
Report Date: 11/22/2019
Date Signed: 11/22/2019 11:06:49 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:BORONDA MEADOWS ELEMENTARY PRESCHOOLFACILITY NUMBER:
274408742
ADMINISTRATOR:ROSIE A. ALVAREZFACILITY TYPE:
850
ADDRESS:915 LARKIN DRIVETELEPHONE:
(831) 753-0648
CITY:SALINASSTATE: CAZIP CODE:
93907
CAPACITY:48CENSUS: 34DATE:
11/22/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Denise NoelTIME COMPLETED:
11:15 AM
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Licensing Program Analyst (LPA), Behbood, conducted an unannounced random visit to the Facility today. LPA met with Denise Noel, Program Coordinator. Purpose of the visit explained. LPA toured both inside and outside of the facility during today's visit.
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), Menus (includes current and following week), and Activity Schedule. Facility operates during school year only, there are 2 sessions AM and PM which is from 8 to 11 and 12 to 3.
All staff have clearances through school through the School District. Title 5 staffing ratio was met. No bodies of water observed.
LPA reviewed samples of children's file and sign in and out sheets during today's visit. Each child's file reviewed contains the Information and Emergency Information form (LIC 700) and a copy of the admission agreement. LPA observed that all children were properly signed in and out (legal signature & time of day) by a parent or authorized representative. A few staff have current CPR and First Aid certifications and proof of immunization on file . Staff files have copies of their educational background. Furniture & equipment appear in good condition. Floors appear clean. Children's bathrooms are in operating condition.
Lunch is provided by the district and served in the cafeteria. Trash can for food waste has a tight fitting cover. Menu is posted
Playground has climbing structures, sand boxes, etc. Wood chips are used for cushioning material.
Drinking water inside the classrooms and in the playground are provided via water fountains. This facility provides Incidental Medical Services (IMS). LPA reviewed storage of medication and equipment /supplies, and reviewed children’s, personnel and administrative records.
Exit interview conducted.
No citation issued during today's visit.
SUPERVISOR'S NAME: Anthony StudebakerTELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Mahvash BehboodTELEPHONE: (408) 334-8552
LICENSING EVALUATOR SIGNATURE:

DATE: 11/22/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/22/2019
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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