274408917-9-12-2022-07-CC-SCES-CJ7RD2-20220912125513

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 274408917
Report Date: 09/12/2022
Date Signed: 09/12/2022 12:55:19 PM

Document Has Been Signed on 09/12/2022 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:	GABILAN STATE PRESCHOOL		FACILITY NUMBER:	274408917
ADMINISTRATOR:	ANGELA EHRLICH		FACILITY TYPE:	850
ADDRESS:	330 N. WALKER		TELEPHONE:	(831) 678-1581
CITY:	SOLEDAD	STATE: CA	ZIP CODE:	93960
CAPACITY:	24	CENSUS: 35	DATE:	09/12/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:			TIME COMPLETED:	01:05 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 09/12/2022 at 10:00 AM, Licensing Program Analyst (LPA), Susy Cervantes, met with program manager, Lori Morones, for an annual inspection and explained the nature of today's visit to them. LPA toured the Facility both inside and outside for today's inspection. 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, Menus, and Activity Schedule. There is one active waiver to share the playground with the kindergarten program. All staff are fingerprinted and cleared by Soledad Unified School District LPA reviewed 10 children and six staff's files during today's inspection and observed that all required documentation is on file. Staff 01, 02, 04, 05, and 06 have current CPR and first aid. Manager 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 (field trips). LPA observed 18 children in the AM class and 17 children in the PM class during today's visit. Manager understands the conditions, limitations, and capacity specifications of the facility license. Manager understands that children shall be visually supervised at all times. LPA observed the facility is clean and safe for all children and staff. Drinking water is readily available for the children in each room and in the outdoor playground area via water bottles. LPA observed solid waste containers with tight-fitting lids in the facility. Children's bathrooms are clean, sanitary, and operable. There is a separate staff toilet not utilized by the children which an isolated child can use if needed. Manager stated that there are no weapons or firearms on the premises. *Continues on report dated 09/12/2022 pg.1/2*

SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Susy Cervantes	TELEPHONE: (408) 598-9403
LICENSING EVALUATOR SIGNATURE:	DATE: 09/12/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/12/2022

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: GABILAN STATE PRESCHOOL	FACILITY NUMBER: 274408917
	VISIT DATE: 09/12/2022

NARRATIVE

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Continuation of report dated 09/12/2022 pg. 2/2

The food is prepared by the Gabilan Elementary School. Cleaning supplies are inaccessible to the children and stored in high cabinets inaccessible to children. Any poisons are locked and stored inaccessible to the children. Any medications at the facility are stored in the nurse's office. 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 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 and in good condition. The playground canopy provides shade for the day care children. LPA did not observe any bodies of water.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

No deficiencies were cited during today's visit. Manager was informed that failure to correct the deficiencies by the specified Plan of Correction Due Date will result in assessment of civil penalties in the amount of $100 per day per violation until the correction is made. Exit interview conducted and report was reviewed with the manager, Lori Morones. A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Susy Cervantes	TELEPHONE: (408) 598-9403
LICENSING EVALUATOR SIGNATURE:	DATE: 09/12/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/12/2022

LIC809 (FAS) - (06/04)

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