434413667-7-18-2019-07-CC-SYIP-BE7NG7-20190718102641

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434413667
Report Date: 07/18/2019
Date Signed: 07/18/2019 10:26:48 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:	ONE WORLD AFTER SCHOOL-PROGRAM		FACILITY NUMBER:	434413667
ADMINISTRATOR:	MELISSA ALVAREZ		FACILITY TYPE:	840
ADDRESS:	277 IOOF AVE		TELEPHONE:	(408) 460-1797
CITY:	GILROY	STATE: CA	ZIP CODE:	95020
CAPACITY:	25	CENSUS: 0	DATE:	07/18/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	08:36 AM
MET WITH:	Jessica Vegas and Melissa Alvarez		TIME COMPLETED:	10:35 AM

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) Samantha Yip and Marilou Monico conducted an unannounced annual random inspection and a change in room. LPAs met with Jessica Vegas and Owner/Director Melissa Alvarez and explained the purpose of the inspection. Facility is changing rooms from Room 10 to Room 12. Facility is located on Gilroy Prep School and is currently licensed under Room 10. Present during the inspection were 2 staff. There were no daycare children present during the inspection. Jessica stated that the facility will use Room 15 for the Kindergarteners for an hour after dismissal. The hours of operation are Monday, Tuesday, Thursday, Friday 2PM-6PM and Wednesdays 12:30PM -6PM. Fire clearance for Room 12 was granted on 07/08/2019. LPAs measured Room 12. The measurements for Room 12 are as followed: 39.333 x 22.750 = 894.825 minus encumbered space 2.167 x 8 = 850.764 Total Indoor Space= 877.489 divided by 35 = 25 children Outdoor measurement were conducted on 08/04/2017. The outdoor measurements are as followed. SCHOOL PLAYGROUND: 191.332 x 134.332 = 25,703.010 TOTAL OUTDOOR SPACE: 25,703.010 sq. ft. divided by 75 = 342 children. There are 8 tables and 32 chairs in the classroom. The school is currently cleaning and repainting the outside of the building. There is no hooks installed for the children outside of the classroom. Melissa stated that she will submit a picture of the hooks when installed. LPAs observed the bathroom for children's use. There are 13 toilets (195), 4 urinals (30) and 7 sinks (105) available for the school age children. LPAs discussed with Owner about supervision of children when they need to use the restroom. Drinking water is provided through water fountains inside and outside. LPA observed a fully charged fire extinguisher, -----continues on 809 dated 07/18/2019 page 2----------------

SUPERVISOR'S NAME: Anthony Studebaker	TELEPHONE: (408) 324-2148
LICENSING EVALUATOR NAME: Samantha Yip	TELEPHONE: (408) 529-8128
LICENSING EVALUATOR SIGNATURE:	DATE: 07/18/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/18/2019

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: ONE WORLD AFTER SCHOOL-PROGRAM	FACILITY NUMBER: 434413667
	VISIT DATE: 07/18/2019

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----continuation of 809 dated 07/18/2019 page 1---------------

functioning smoke detector, and carbon monoxide detector. There are sufficient of amount of equipment for the children in care. All disinfectants, cleaning supplies, and other things that are dangerous to children are stored inaccessible to children. Facility does provide snacks to children in care. All snacks are prepared in the Room 11- Staff Lounge. There is tight-fitted storage container for waste.

Facility will use the playground on the school campus. Areas around play structures were cushioned with resilient materials to absorbs falls. Shaded rest areas are provided through trees. LPAs did not observe any bodies of water.

Staff present during the inspection have cleared criminal record and child abuse index clearance or exemption. LPA also reminded Director 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 violation within a 12 month period.

Facility does provide Incidental Medical Services. All medications are stored in a container, which is stored in the Room 11. 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.

A license for Room 12 will be approved upon completion of:
1. proof of hooks to store children's backpacks

As a result of this inspection, no deficiencies were cited . An exit interview was conducted, where this report was discussed and provided to Licensee/Director Melissa.

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: 07/18/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/18/2019

LIC809 (FAS) - (06/04)

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