350700523-9-20-2022-07-CC-DVIA-CJFQWR-20220920123223

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 350700523
Report Date: 09/20/2022
Date Signed: 09/20/2022 12:32:33 PM

Document Has Been Signed on 09/20/2022 12:32 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:	PRESBYTERIAN CO-OPERATIVE PRESCHOOL		FACILITY NUMBER:	350700523
ADMINISTRATOR:	WENDY SUE CLARK SHEPHERD		FACILITY TYPE:	850
ADDRESS:	2066 SAN BENITO STREET		TELEPHONE:	(831) 630-1234
CITY:	HOLLISTER	STATE: CA	ZIP CODE:	95023
CAPACITY:	60	CENSUS: 30	DATE:	09/20/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:40 AM
MET WITH:	Wendy Shepherd		TIME COMPLETED:	12:40 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 Analyst (LPA), Deanna Villagrana, conducted an unannounced required one year inspection to the Facility today. LPA met with director, Wendy Shepherd and explained the nature of today's visit to her. The Facility is licensed in room P1, P2 and P3 located at Christ Fellowship church. The playground area of the Facility is located behind the classrooms. 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, and Activity Schedule. A review of staff records on 09/19/2022 indicates that all Facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions Director Wendy Shepherd was reminded that all adults 18 and over, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated. LPA reviewed ten children's and three teachers files during today's inspection. All staff and children's files were complete. One staff have current CPR and First Aid certifications on file. All three staff files reviewed contain the required transcripts/verification of experience. Wendy 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).

SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Deanna Villagrana	TELEPHONE: (408) 335-9890
LICENSING EVALUATOR SIGNATURE:	DATE: 09/20/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2022

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: PRESBYTERIAN CO-OPERATIVE PRESCHOOL	FACILITY NUMBER: 350700523
	VISIT DATE: 09/20/2022

NARRATIVE

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LPA observed that the teacher/child ratio was in compliance during today's visit. LPA observed 13 preschool children with one teacher and three parents in room P3, seven preschool children with one teacher and one parent in P2 and 10 preschool children with one teacher and two parents in room P1. Wendy understands the conditions, limitations, and capacity specifications of the Facility license. Wendy understands that children shall be visually supervised at all times. LPA observed that all rooms are clean and safe for all children and staff. Wendy states that the Facility staff and teachers rotate cleaning duties on a weekly basis at the Facility. Children bring their own water containers and the facility has extra water bottles available if needed. 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 toilet not utilized by the children which an isolated child can use if needed. Wendy states 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 locked cabinets in the office. Any medications at the Facility are stored in the director's office area. LPA observed IMS is administered by the Facility to two children at this time.

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. Several trees, two canopies and tarps provide shade for the day care children. LPA did not observe any bodies of water.

Exit interview conducted and report was reviewed with the licensee Wendy Shepherd.

No deficiencies were cited.

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.

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.

SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Deanna Villagrana	TELEPHONE: (408) 335-9890
LICENSING EVALUATOR SIGNATURE:	DATE: 09/20/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2022

LIC809 (FAS) - (06/04)

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