274416181-8-1-2019-07-CC-JMAS-BEMPWZ-20190801114134

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 274416181
Report Date: 08/01/2019
Date Signed: 08/01/2019 11:41:43 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:	POTRERO CANYON SCHOOL LLC		FACILITY NUMBER:	274416181
ADMINISTRATOR:	ANDRA BRIANT		FACILITY TYPE:	850
ADDRESS:	5716 CARMEL VALLEY ROAD		TELEPHONE:	(831) 625-0545
CITY:	CARMEL	STATE: CA	ZIP CODE:	93923
CAPACITY:	32	CENSUS: 0	DATE:	08/01/2019
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	08:50 AM
MET WITH:	Andra Briant		TIME COMPLETED:	12:00 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	Licensing Program Analysts (LPA), Joe Macias conducted an announced Prelicensing Inspection. LPA met with the Applicant Andra Briant. The center is located at 5716 Carmel Valley Road, Carmel, CA 93923. The center is located on the Congregation Beth Israel grounds in classrooms 1, 2, 3, and 4. The Congregation Beth Israel grounds also house an adult day program, Paradigm Adult Day Program #275202010. The two programs shall not commingle. The center will operate Monday through Friday from 8:30 AM to 3:30 PM. The Applicant has current CPR and first aid certification on file. The Applicant is scheduled to complete the Preventative Health, Safety & Nutrition training on Saturday August 3, 2019, and will forward the certificate of completion to CCL. A fire safety inspection approval was received from Cypress Fire Protection District prior to today's inspection. LPA toured the facility both inside and out. The following indoor measurements were taken today: PRESCHOOL ROOMS: ROOM 1 17.6 x 21.2 = 373.12 ROOM 2 15.10 x 17.8 = 268.78 ROOM 3 15.7 x 17.8 = 279.46 ROOM 4 15.11 x 17.6 = 265.93 TOTAL INDOOR SPACE = 1,187.29 sq.ft. divided 35 = 33.922 children There are 3 sinks (45), 4 toilets (60) available for the children. Only cold water is available in the children's sinks. There is a separate staff bathroom located in the preschool building. The sick child will use the staff bathroom. The sick child will be isolated in the designated sick room, isolation equipment will be provided. First aid supplies are stored in the preschool storage cabinet, and are inaccessible to children. Cleaning supplies are securely stored and inaccessible to children. LPA observed fully charged 2A10BC fire extinguisher, and working smoke/carbon monoxide detectors. The center will only administer emergency medication and will be stored in a lock box in the office.

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Joseph Macias	TELEPHONE: (408) 334-8320
LICENSING EVALUATOR SIGNATURE:	DATE: 08/01/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/01/2019

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: POTRERO CANYON SCHOOL LLC	FACILITY NUMBER: 274416181
	VISIT DATE: 08/01/2019

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The center will provide snacks for the children, and the parents will provide all lunches. There is separate preparation kitchen shared with Paradigm Adult Day Program #275202010, equipped with oven, microwave, sink and refrigerator. Children shall not be permitted in the kitchen. There is a trash can with tight-fitting lid for the disposal of solid waste.

There are a total of 50 chairs, 8 tables, and 40 cubbies. There is a total of 12 mats/ cots. There is adequate toys, equipment, and supplies for the children. Drinking water is provided indoor via water fountain, water dispenser, and cups. Room temperature is controlled by central heating/air conditioning.

PRESCHOOL YARD:
Total Preschool Yard = 8,137.5
TOTAL OUTDOOR SPACE = 8,137.5 sq.ft. divided 75 = 108 children

The yard is surrounded by appropriate fencing. Shade is provided by trees. Drinking water will be provided by water dispenser and cups. No transportation is provided by the center. There is a working telephone in the office (831) 625-0545.

LPA Macias discussed the requirements of AB 633 to applicant representative and provided her the fact sheet and a copy of Acknowledgement of Receipt of Licensing Reports (LIC 9224) and applicant understands the requirements.

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 conducted an exit interview with the Applicant, LPA advised that the license will be granted pending completion of scheduled Preventative Health, Safety & Nutrition training, as well as Management approval.

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Joseph Macias	TELEPHONE: (408) 334-8320
LICENSING EVALUATOR SIGNATURE:	DATE: 08/01/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/01/2019

LIC809 (FAS) - (06/04)

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