434412013-8-21-2019-07-CC-SYIP-BF9LAS-20190821083533

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434412013
Report Date: 08/20/2019
Date Signed: 08/21/2019 08:35:55 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:	GILROY UNIFIED SCHOOL DISTRICT ROD KELLEY PRE.		FACILITY NUMBER:	434412013
ADMINISTRATOR:	REBECCA LARSEN		FACILITY TYPE:	850
ADDRESS:	8755 KERN AVENUE		TELEPHONE:	(408) 847-7835
CITY:	GILROY	STATE: CA	ZIP CODE:	95020
CAPACITY:	24	CENSUS: 22	DATE:	08/20/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	11:33 AM
MET WITH:	Gayle Darr and Lupe Vela		TIME COMPLETED:	01:15 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) Samantha Yip conducted an unannounced annual random inspection. LPA met with Site Supervisor Gayle Darr and Lupe Vela and explained the reason for the inspection. Upon arrival of inspection, there was Site Supervisor and no daycare children. Facility is located on the Rod Kelly Elementary School site. The hours of operation are 8:15AM to 11:15AM (morning session) and 12:00PM to 3:00PM (afternoon session). At 12:00PM, there were 22 children and 3 staff present. The teacher child ratio was observed to be in compliance during today's inspection. LPA reviewed the sign in/sign out sheet, which contains full legal signature. LPA toured in the inside and outside of the facility with Site Supervisor. The facility was observed to be clean and sanitary. Floors were free of tripping hazard. Disinfectants, cleaning solutions, and all other items that are dangerous to children were observed to be securely stored and inaccessible to children. LPA reminded Site Supervisor to ensure that any cleaning supplies are stored inaccessible to children in care. The furniture and the equipment, such as tables and chair were age-appropriate and in good condition; free of sharp or loose, or pointed parts. LPA observed there is sufficient amount of age-appropriate toys for children in care. Restrooms for children’s use were observed to be safe, sanitary, and in functioning condition. Storage containers for waste have tight fitted lids. Site Supervisor stated that there are no weapons stored on the premise. LPA observed a fully charged fire extinguisher. Site Supervisor stated that they follow the elementary school's fire/disaster drill schedule. -------------continues on 809 dated 08/20/2019 page 2----------------------

SUPERVISOR'S NAME: Anthony Studebaker	TELEPHONE: (408) 324-2148
LICENSING EVALUATOR NAME: Samantha Yip	TELEPHONE: (408) 529-8128
LICENSING EVALUATOR SIGNATURE:	DATE: 08/20/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/20/2019

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: GILROY UNIFIED SCHOOL DISTRICT ROD KELLEY PRE.	FACILITY NUMBER: 434412013
	VISIT DATE: 08/20/2019

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The outdoor activity area is fenced. The playground equipment outside were maintained in safe condition, free of sharp, loose or pointed parts. Areas around play structures were cushioned with resilient materials to absorbs falls. LPA discussed with Site Supervisor about having a staff sweep the playground area to ensure that resilient material is even aden that all gates are closed before children's use. Shaded rest areas are provided through trees and building overhang. LPA did not observe any bodies of water.

Facility does provide snacks to the children in care, which is prepared in the kitchen. Drinking water is provided through individual water bottles and water fountains.

Facility roster was reviewed and a copy was obtained. 10 children’s files were reviewed during today’s inspection. The records reviewed include but not limited to admission agreement, parent's rights, and immunization records.

3 staff files were also reviewed during today's inspection. The records reviewed included but not limited to education credit and Mandated Reporter Training. LPA reminded Site Supervisor that Mandated Reporter Training needs to be renewed every 2 years. There is currently at least one staff on site with a valid CPR/1st Aid, which expires on 10/31/2020. All staff are fingerprinted through Gilroy Unified School District and are monitored by Gilroy Unified School District.

Site Supervisor stated that she currently does not have any children in care who requires Incidental Medical Services (IMS) services. For IMS information, see Evaluator Manual – Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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.

In the areas evaluated durign today's inspection, no deficiencies were cited. An exit interview was conducted, where this report was discussed and provided to Lupe Vela. A NOTICE OF SITE VISIT WAS ISSUE AND MUST BE POSTED FOR 30 CONSECUTIVE DAYS.

SUPERVISOR'S NAME: Anthony Studebaker	TELEPHONE: (408) 324-2148
LICENSING EVALUATOR NAME: Samantha Yip	TELEPHONE: (408) 529-8128
LICENSING EVALUATOR SIGNATURE:	DATE: 08/20/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/20/2019

LIC809 (FAS) - (06/04)

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