274410785-7-7-2023-07-CC-SCES-CTHV77-20230707161041

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 274410785
Report Date: 07/07/2023
Date Signed: 07/07/2023 04:10:48 PM

Document Has Been Signed on 07/07/2023 04:10 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:	M.A.O.F. GREENFIELD EARLY LEARNING CENTER		FACILITY NUMBER:	274410785
ADMINISTRATOR:	JENNIFER MANCERA		FACILITY TYPE:	850
ADDRESS:	131 13TH ST		TELEPHONE:	(831) 674-5810
CITY:	GREENFILED	STATE: CA	ZIP CODE:	93927
CAPACITY: 48	TOTAL ENROLLED CHILDREN: 48	CENSUS: 21	DATE:	07/07/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:10 PM
MET WITH:	Janet Kindred		TIME COMPLETED:	04:20 PM

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On 07/07/2023 at 1:10 PM, Licensing Program Analyst (LPA), Susy Cervantes, met with director, Janet Kindred, 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 are no active waivers at this time.

A listing of staff criminal record clearances associated to this facility in the CCL Licensing Information System (LIS) on 07/07/2023 was reviewed and it indicates that all Facility staff or other individuals who require caregiver background clearances have received criminal record and child abuse index clearances or exemptions. Director was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

LPA reviewed 6 children and 5 staff's files during today's inspection and observed that staff 01 and 02 are missing proof of MMR vaccination. Staff 04 & 05 have current CPR and first aid. Director 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 that the teacher/child ratio was in compliance during today's visit. LPA observed twenty one preschool children with two teachers, one aid and two volunteers at the facility. Director understands the conditions, limitations, and capacity specifications of the facility license. Director understands that children shall be visually supervised at all times.

Continues on report dated 07/07/2023_______________________________________ pg. 1/3

NAME OF LICENSING PROGRAM MANAGER: Mary Segura
NAME OF LICENSING PROGRAM ANALYST: Susy Cervantes
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2023

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: M.A.O.F. GREENFIELD EARLY LEARNING CENTER	FACILITY NUMBER: 274410785
	VISIT DATE: 07/07/2023

NARRATIVE

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Continuation of report dated 07/07/2023_______________________________________ pg. 2/3

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 dispenser/disposable cups. 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. Director stated that there are no weapons or firearms on the premises.

The food preparation and storage areas are clean, free of litter & rubbish, and free of rodents and other vermin. All food and beverages that require refrigeration are stored in covered containers at 45 degrees F or less. Cleaning supplies are inaccessible to the children and stored in high cabinets. Any poisons are stored in locked cabinets inaccessible to children. Medications at the facility are stored in the office. This facility provides Incidental Medical Services – IMS. LPA reviewed storage of “medication and equipment/supplies, and reviewed children’s, personnel, and administrative records.

For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication. Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-carecenters/.

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 canopies provide shade for the day care children. There is also sufficient resilient materials (pour and play) in the outdoor playground area. LPA did not observe any bodies of water.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test.

For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1CCP).

NAME OF LICENSING PROGRAM MANAGER: Mary Segura
NAME OF LICENSING PROGRAM ANALYST: Susy Cervantes
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2023

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: M.A.O.F. GREENFIELD EARLY LEARNING CENTER	FACILITY NUMBER: 274410785
	VISIT DATE: 07/07/2023

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Continuation of report dated 07/07/2023_______________________________________ pg. 3/3
LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

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.

Director was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Type B deficiency was cited during today's visit. Director 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 director, Janet Kindred. A notice of site visit was given and must remain posted for 30 days.

NAME OF LICENSING PROGRAM MANAGER: Mary Segura
NAME OF LICENSING PROGRAM ANALYST: Susy Cervantes
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 07/07/2023 04:10 PM - It Cannot Be Edited

Created By: Susy Cervantes On 07/07/2023 at 03:51 PM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: M.A.O.F. GREENFIELD EARLY LEARNING CENTER	FACILITY NUMBER: 274410785
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/07/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.7995(a)(1)

General Provisions and Definitions

(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in which staff 01 and 02 are missing proof of Measle vaccination which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 07/21/2023
	Plan of Correction
1 2 3 4	Director will submit proof of vaccination for MMR for staff 01 and 02 to the San Jose Regional Office by close of business on July 21, 2023.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME:

Mary Segura

LICENSING EVALUATOR NAME:

Susy Cervantes

LICENSING EVALUATOR SIGNATURE:

DATE: 07/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2023

LIC809 (FAS) - (06/04)

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