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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 354400147
Report Date: 08/09/2021
Date Signed: 08/09/2021 01:51:47 PM

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:LITTLE BALER PRESCHOOLFACILITY NUMBER:
354400147
ADMINISTRATOR:RHODES, RENEFACILITY TYPE:
850
ADDRESS:1520 SUNNYSLOPE ROADTELEPHONE:
(831) 637-4326
CITY:HOLLISTERSTATE: CAZIP CODE:
95023
CAPACITY:72CENSUS: 52DATE:
08/09/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:40 AM
MET WITH:Rene RhodesTIME COMPLETED:
02:00 PM
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Licensing Program Analyst (LPA), Deanna Villagrana, conducted a required one year visit to the Facility today. LPA met with Rene Rhodes, director, and explained the nature of today's visit to her. The Facility is licensed in several rooms in a building at Sunnyslope Christian Center. The playground area of the Facility is located behind the classrooms and in between the church and building.

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.

A review of staff records on 08/04/2021 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 reminded Rene 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. Penalty amounts: $100.00 per person per day, minimum of $100.00 to a maximum of $500.00 per person for an initial violation and a minimum of $100.00 to a maximum of $3000.00 per person for any subsequent violations within a 12 month period.

LPA reviewed ten children's and seven staff (6 teachers and 1 aide) files during today's inspection. Children's files were complete. All six teachers including director have current CPR and First Aid certifications on file. Not all staff files reviewed contain the required transcripts/verification of experience. All staff have completed Mandated Reporter Training and have current immunization records on file. Rene 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 SeguraTELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Deanna VillagranaTELEPHONE: (408) 335-9890
LICENSING EVALUATOR SIGNATURE:

DATE: 08/09/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 3
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: LITTLE BALER PRESCHOOL
FACILITY NUMBER: 354400147
VISIT DATE: 08/09/2021
NARRATIVE
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LPA observed that the teacher/child ratio was in compliance during today's visit. LPA observed three preschool children with one teacher in the 3's room, ten preschool children with one teacher in another 3's room, 11 preschoolers with one teacher in the 4's room, 22 preschoolers in another 4's room with two teachers and 4 preschoolers in the 2's room with one teacher and one aide. Rene understands the conditions, limitations, and capacity specifications of the Facility license. Sandra understands that children shall be visually supervised at all times. LPA observed that all rooms are clean and safe for all children and staff. Rene states that the Facility staff rotate cleaning duties on a weekly basis at the Facility. Drinking water is readily available for the children in each room and in the outdoor playground area via water jug/disposable 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 toilet not utilized by the children which an isolated child can use if needed. Rene 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 a locked storage located in the children's bathroom and are inaccessible to children. Any poisons are stored in locked storage cabinets. Any medications at the Facility are stored above the refrigerator. There is none being stored 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. LPA observed that the Facility needs to add 3-4 inches of additional resilient materials (wood chips) in the playground area. Building overhang and a wood patio provide shade for the day care children. LPA did not observe any bodies of water.

The following type B deficiencies were cited on the attached page (809-D). Rene was informed that failure to correct the deficiencies by the specified Plan of Correction (POC) Due Date may result in assessment of civil penalties in the amount of $100 per day per violation until the correction is made.

Licensing Forms, Title 22 Regulations, and information can be obtained through the internet at www.cdss.ca.gov. Appeal rights were provided to Rene prior to the conclusion of today's visit.



A NOTICE OF SITE VISIT WAS ISSUED, POSTED NEAR THE FACILITY ENTRANCE, AND MUST REMAIN POSTED FOR 30 DAYS.
SUPERVISOR'S NAME: Mary SeguraTELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Deanna VillagranaTELEPHONE: (408) 335-9890
LICENSING EVALUATOR SIGNATURE:

DATE: 08/09/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2021
LIC809 (FAS) - (06/04)
Page: 2 of 3
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: LITTLE BALER PRESCHOOL
FACILITY NUMBER: 354400147
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/09/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/16/2021
Section Cited

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As a condition of licensure, the areas around and under high climbing equipment, swings, slides and other similar equipment shall be cushioned with material that absorbs falls.
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This requirement was not met as evidenced by LPA observed that the Facility needs to add 3-4 inches of additional resilient materials (wood chips) in the playground area. This poses a potential risk Health, Safety Personal Rights risk to children in care.
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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 SeguraTELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Deanna VillagranaTELEPHONE: (408) 335-9890
LICENSING EVALUATOR SIGNATURE:
DATE: 08/09/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/09/2021
LIC809 (FAS) - (06/04)
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