274415464-9-10-2019-07-CC-JMAS-BFVP9W-20190910110748

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 274415464
Report Date: 09/10/2019
Date Signed: 09/10/2019 11:07:56 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:	PACIFIC GROVE ADULT EDUCATION CDC		FACILITY NUMBER:	274415464
ADMINISTRATOR:	BARBARA MARTINEZ		FACILITY TYPE:	850
ADDRESS:	1025 LIGHTHOUSE AVENUE		TELEPHONE:	(831) 646-6623
CITY:	PACIFIC GROVE	STATE: CA	ZIP CODE:	93950
CAPACITY:	30	CENSUS: 21	DATE:	09/10/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	08:50 AM
MET WITH:	Kellyann Joyce		TIME COMPLETED:	11:15 AM

NARRATIVE

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Licensing Program Analyst (LPA) Joe Macias conducted an Annual Random Inspection. LPA met with the Head Teacher Kellyann Joyce, and explained the nature of today's visit. LPA toured the Facility both inside and outside during todays visit. LPA noted that the Facility is located on the Pacific Grove Adult Education School campus, in rooms 17, and 18. The center has a toddler component. 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 - 6pm.

LPA reviewed children, and 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 Pacific Grove Unified School District. Director and 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, or present during off-site activities (field trips).

Director understands the conditions, limitations, and capacity specifications of the Facility license. Director understands that children shall be visually supervised at all times. LPA observed that all rooms are clean and in order. Drinking water is readily available for the children in each room and in the outdoor playground area via drinking fountain, water dispensers and cups. LPA observed solid waste containers with tight-fitting lids in each room. Staff and children's bathrooms are clean, sanitary. There is a separate staff bathroom not utilized by the children which an isolated child can use if needed. Director states that there are no weapons or firearms on the premises.

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. LPA did not observe any bodies of water.

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Joseph Macias	TELEPHONE: (408) 334-8320
LICENSING EVALUATOR SIGNATURE:	DATE: 09/10/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2019

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: PACIFIC GROVE ADULT EDUCATION CDC	FACILITY NUMBER: 274415464
	VISIT DATE: 09/10/2019

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LPA also discussed ratio, there shall be a ratio of one teacher visually observing and supervising no more than 12 children in attendance. The center may use teacher aides in a teacher-child ratio of one teacher and one aide for every 15 children in attendance. A teacher-child ratio of one teacher supervising 24 napping children is permitted provided that the remaining teachers necessary to meet the overall ratio specified in Section 101216.3(a) are immediately available at the center. An aide who is 18 years of age or older, and who meets the requirements of Sections 101216 and 101216.2, may supervise 24 napping children in place of a teacher if the conditions specified in (c) above are met.

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. Director states that the Facility does not administer medications at this time.

Licensing Forms, Title 22 Regulations and information can be obtained through the internet at www.cdss.ca.gov.

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

All staff have completed the Mandated Reporter Training.

LPA advised the Director of the new immunization requirement (pertussis, measles, and flu vaccines) for all staff and volunteers that work directly with the children.

No deficiencies cited, 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: 09/10/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2019

LIC809 (FAS) - (06/04)

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