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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434400273
Report Date: 11/14/2019
Date Signed: 11/14/2019 05:14:43 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:EL TORO CDC - SCHOOL AGEFACILITY NUMBER:
434400273
ADMINISTRATOR:JULIZA PONCEFACILITY TYPE:
840
ADDRESS:455 EAST MAIN STREETTELEPHONE:
(408) 778-1402
CITY:MORGAN HILLSTATE: CAZIP CODE:
95037
CAPACITY:59CENSUS: 15DATE:
11/14/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
03:57 PM
MET WITH:Juliza PonceTIME COMPLETED:
05:15 PM
NARRATIVE
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Licensing Program Analyst (LPA) Samantha Yip conducted unannounced annual random inspection. LPA met with Site Director Juliza Ponce and explained the reason for the inspection. Present during the inspection were 15 school-age children and 3 staff. The teacher child ratio was in compliance during today's inspection. The facility is located on El Toro Elementary School campus.

LPA reviewed the sign in/sign out sheet. License, Emergency Disaster Plan, and Notification of Parents were posted. There is working phone at the center.

LPA toured the center with Site Director. The facility was observed to be cleaned and sanitary. LPA observed that there was sufficient amount of toys and equipment for children in care. Furniture and equipment, such as tables and chairs, were observed to in good condition. All disinfectant, cleaning supplies, and other items were stored inaccessible to children. Director stated that there are no weapons, such as firearms, stored on the premise. Bathroom for children's use was observed. LPA observed a fully charged fire extinguisher, smoke detector, and carbon monoxide detector. The facility uses the blacktop and grass area on the elementary school site. Area is fenced. There were no bodies of water observed during today's inspection.

Facility does provide snacks to the children in care. The area to prepare snacks was observed to be clean and sanitary. Drinking water is provided through water cooler and cups.

-------------------continues on 809 dated 11/14/2019 page 2--------------------------------------
SUPERVISOR'S NAME: Anthony StudebakerTELEPHONE: (408) 324-2148
LICENSING EVALUATOR NAME: Samantha YipTELEPHONE: (408) 529-8128
LICENSING EVALUATOR SIGNATURE:

DATE: 11/14/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/14/2019
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 2
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: EL TORO CDC - SCHOOL AGE
FACILITY NUMBER: 434400273
VISIT DATE: 11/14/2019
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-------------------------continuation of 809 dated 11/14/2019 page 1------------------------------

A copy of the facility roster was obtained. 4 children's file were reviewed. The record reviewed include but not limited to the admission agreement.

One staff file was also reviewed during today's inspection. Staff has a valid CPR/1st Aid, which expires on 03/24/2020. All staff present during today's inspection have cleared criminal clearance and child abuse index clearance.

Site Director stated that she currently does have children in care who requires Incidental Medical Services (IMS) services. Medication is properly stored where it is out of the reach of children and with the proper documents. 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.

No deficiencies were cited as a result of today's inspection. An exit interview was conducted, where this report was discussed with Site Director Juliza Ponce.

A NOTICE OF SITE VISIT WAS ISSUE AND MUST BE POSTED FOR 30 CONSECUTIVE DAYS.
SUPERVISOR'S NAME: Anthony StudebakerTELEPHONE: (408) 324-2148
LICENSING EVALUATOR NAME: Samantha YipTELEPHONE: (408) 529-8128
LICENSING EVALUATOR SIGNATURE:

DATE: 11/14/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/14/2019
LIC809 (FAS) - (06/04)
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