354416171-8-21-2019-07-CC-JMAS-BF9VVT-20190821164653

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 354416171
Report Date: 08/21/2019
Date Signed: 08/21/2019 04:46:58 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:	CALAVERAS HEAD START		FACILITY NUMBER:	354416171
ADMINISTRATOR:	RENEE GARCIA		FACILITY TYPE:	850
ADDRESS:	1081 BUENA VISTA ROAD		TELEPHONE:	(408) 573-4071
CITY:	HOLLISTER	STATE: CA	ZIP CODE:	95023
CAPACITY:	72	CENSUS: 0	DATE:	08/21/2019
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	02:20 PM
MET WITH:	Renee Garcia		TIME COMPLETED:	04:45 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), Joseph, conducted an announced Prelicensing Inspection. LPA met with Renee Garcia, Supervisor of Preschool Sites. The center will operate Monday through Friday from 8 AM to 5 PM. The center is operated by Santa Clara County Office of Education and all staff are fingerprinted through the Department of Education. The head teacher has current CPR and first aid certification on file. A fire safety inspection approval was received from Hollister Fire Department prior to today's inspection. LPA toured the facility both inside and out. The following indoor measurements were taken today: PRESCHOOL ROOMS: ROOM #101 37 x 23.8 = 880.6 ROOM #105 37 x 24.4 = 902.8 ROOM #112 37 x 23.1 = 854.7 TOTAL INDOOR SPACE = 2,638.1 sq.ft. divided 35 = 75.374 children There are 13 sinks (195) and 6 toilets (90) available for the children. Only cold water is available in the children's sinks. There is one staff bathroom located in the preschool office. The sick child will use the staff bathroom located in the office. The sick child will be isolated in the director's office and isolation equipment is provided. First aid supplies are stored in the classroom, and are inaccessible to children. Cleaning supplies are securely stored and inaccessible to children. The center will only administer emergency medication and will be stored in a lock box in the office. This is a full-day program and the center will provide breakfast, lunch and snacks for the children. There is a kitchen located in the office that is equipped with hot and cold running water, microwave, dishwasher, small oven, and refrigerator. There is a trash can with tight-fitting lid for the disposal of solid waste.

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Joseph Macias	TELEPHONE: (408) 334-8320
LICENSING EVALUATOR SIGNATURE:	DATE: 08/21/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/21/2019

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: CALAVERAS HEAD START	FACILITY NUMBER: 354416171
	VISIT DATE: 08/21/2019

NARRATIVE

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There are 61 chairs, 15 tables, and 60 cubbies. Napping equipment is age appropriate, there is a total of 60 cots. There is adequate toys, equipment, and supplies for the children. Drinking water is provided indoor via water dispenser, pitchers, and cups. Room temperature is controlled by central heating/air conditioning.

PRESCHOOL YARD:
Total Preschool Yard = 115.4 x 61.5 = 7,097.1
TOTAL OUTDOOR SPACE = 7,097.1 sq.ft. divided 75 = 94.628 children

The yard is surrounded by appropriate fencing. Shade is provided by trees, and the building awning. The yard has a climbing structure with tanbark as resilient material. Drinking water will be provided by water dispensers, pitchers and cups. No transportation is provided by the center. There is a working telephone in the classroom (408)573-4072.

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 Applicants, LPA advised the Applicants that the license will be granted pending Management approval.

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Joseph Macias	TELEPHONE: (408) 334-8320
LICENSING EVALUATOR SIGNATURE:	DATE: 08/21/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/21/2019

LIC809 (FAS) - (06/04)

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