274410782-6-11-2019-07-CC-JMAS-BD2PHZ-20190611112046

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 274410782
Report Date: 06/11/2019
Date Signed: 06/11/2019 11:20:51 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:	CSUMB CHILD DEVELOPMENT CENTER		FACILITY NUMBER:	274410782
ADMINISTRATOR:	JENNIFER SEBOLINO		FACILITY TYPE:	830
ADDRESS:	100 CAMPUS CENTER BLD. #91		TELEPHONE:	(831) 582-4550
CITY:	SEASIDE	STATE: CA	ZIP CODE:	93955
CAPACITY:	12	CENSUS: 6	DATE:	06/11/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:46 AM
MET WITH:	Jennifer Sebolino		TIME COMPLETED:	11:30 AM

NARRATIVE

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Licensing Program Analyst (LPA) Joe Macias conducted an announced Random Annual Inspection. The purpose of today’s visit is to ensure the facility is in compliance with Title 22 California Code of Regulations. LPA met with the Site Supervisor Jennifer Sebolino, and explained the nature of today's visit. LPA toured the Facility both inside and outside during todays visit. The Facility also has a preschool program (#274410781) on site. 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. The hours of operation are Monday - Friday, 7am - 5:30pm. The facility has an active waiver which allows the Infant program to share the space used by the preschool children between 7:00 a.m. to 8:00 a.m. and 4:30 p.m. to 5:30 p.m.

LPA reviewed four children's and four 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, as well as Needs & Services Plans. Needs & Services Plans also include individual feeding plans for each child and are updated at least once every three months or sooner if needed. The Site Directors file contain the required transcripts/verification of experience. Director and all staff have current CPR and First Aid certifications on file. The Director understands that there shall be at least one person, with valid CPR and First Aid certifications, on site at all times in each licensed program (infant & preschool) or present during off-site activities (field trips).

The Program Director understands the conditions, limitations, and capacity specifications of the Facility license. Director understands that infants shall be visually supervised at all times and never left unattended. LPA observed that all rooms are 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 dispensers, and sippie cups. LPA observed solid waste containers with tight-fitting lids in the Facility. Staff and children's bathrooms are clean, sanitary, and operable. There is a separate staff bathroom not utilized by the children which an isolated child can use if needed. The Director states that there are no weapons or firearms on the premises.

The food preparation and storage areas are clean, free of litter, rubbish, rodents and other vermin. Cleaning supplies are securely stored and inaccessible to the children. LPA observed a fully charged 2A10BC fire extinguisher, and working smoke/carbon monoxide detectors.

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Joseph Macias	TELEPHONE: (408) 334-8320
LICENSING EVALUATOR SIGNATURE:	DATE: 06/11/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/11/2019

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: CSUMB CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 274410782
	VISIT DATE: 06/11/2019

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LPA observed all furniture and equipment is in good condition and safe for the children. The infant changing table has raised sides that are at least 3 inches in height. The infant changing table(s) has a vinyl changing pad that is at least 1 inch think and in good condition. Napping equipment is appropriate.

The playground area utilized by children is surrounded by appropriate fencing and the outdoor surfaces are safe for the children. The infant playground is separate from the preschool playground. LPA observed that the outdoor equipment is age appropriate and in good condition. There are sufficient resilient materials in the outdoor playground area. LPA did not observe any bodies of water.

LPA also went over safe sleep for infants.

A review of staff records on June 11, 2019 indicates that all Facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. LPA also reminded Licensee 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. A $500 immediate civil penalty. An ongoing $100 per day per violation continues until the violation(s) is corrected.

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 staff immunization records on file.

All staff have completed the Mandated Reporter Training.

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

A NOTICE OF SITE VISIT WAS ISSUED, POSTED NEAR THE ENTRANCE TO THE FACILITY, AND MUST REMAIN POSTED FOR 30 DAYS.

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Joseph Macias	TELEPHONE: (408) 334-8320
LICENSING EVALUATOR SIGNATURE:	DATE: 06/11/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/11/2019

LIC809 (FAS) - (06/04)

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