444408785-9-28-2022-07-CC-CNEN-CJPT76-20220928142813

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 444408785
Report Date: 09/28/2022
Date Signed: 09/28/2022 02:28:21 PM

Document Has Been Signed on 09/28/2022 02:28 PM - It Cannot Be Edited

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:	CKC CHILDREN'S CENTER		FACILITY NUMBER:	444408785
ADMINISTRATOR:	ELISA BRIDGES		FACILITY TYPE:	850
ADDRESS:	8005 WINKLE AVENUE		TELEPHONE:	(831) 475-6587
CITY:	SANTA CRUZ	STATE: CA	ZIP CODE:	95065
CAPACITY:	42	CENSUS: 13	DATE:	09/28/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:05 AM
MET WITH:	Noel Shermann		TIME COMPLETED:	02:38 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), Cortney Nelson, met with Executive Director, Noel Shermann, for an unannounced Required- 1 Year Inspection. LPA was granted access to the facility by a staff member, conducted COVID risk assessment, and toured both indoors and outdoors during the inspection. Upon arrival, there were 13 preschool-age children and 6 staff present, which is compliant with the facility license capacity and ratio requirements. LPA observed all required postings near the entrance to the facility. Hours of operation for the facility are Monday – Friday, 7:30AM-5:30PM. The facility is located on the campus of Santa Cruz Gardens Elementary School in the Campus Kids Connection (CKC), Inc building located near the parking lot. There is another licensed CKC facility on campus for school-age children located in room 46. LPA reviewed sign-in/out sheets, facility roster (LIC9040), and fire/disaster drill log during today’s inspection. Sign-in/out was observed to be completed using the app, Brightwheel with full legal signature and time of day. Noel states that in addition to electronic sign-in/out, staff maintain a paper roster as children arrive in case of WiFi outages or other issues with the application. The last fire/disaster drill was conducted on 8/16/2022, which is compliant with the six-month requirement for facilities. During todays inspection, LPA observed the facility partake in a school wide lock down drill and Noel states that they occur monthly. LPA observed two (2) fully charged 3A40BC fire extinguishers (last serviced: 8/2022) and two (2) functioning carbon monoxide detectors. The facility has a built in smoke detector system that is hooked up to the entire school campus. Noel states that she does not currently have any children in care who require Incidental Medical Services and does not administer medication at this time. Noel additionally states that there are no weapons or firearms on the premises. Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual- Regulation Interpretations and Procedures for Child Care Centers, Section 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 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

SUPERVISOR'S NAME: Joel Segura	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Cortney Nelson	TELEPHONE: (916) 956-5037
LICENSING EVALUATOR SIGNATURE:	DATE: 09/28/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2022

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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Document Has Been Signed on 09/28/2022 02:28 PM - It Cannot Be Edited

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: CKC CHILDREN'S CENTER	FACILITY NUMBER: 444408785
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/28/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101212(b)

Reporting Requirements

(b) The name of the child care center director, and any fully qualified teacher(s) designated to act in the child care center director's absence, shall be reported to the Department within 10 days of a change of child care center director or designee(s). This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, interview, and record review, the licensee did not comply with the section cited above for changes in Site Director at the facility, which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 10/17/2022
	Plan of Correction
1 2 3 4	The Executive Director, Noel, will submit Site Director Qualifications packet for review by 10/17/2022. LPA provided Noel with copy of 101212 Reporting Requirements from the Title 22 California Code of Regulations to review Child Care Center reportable incidents.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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: Joel Segura	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Cortney Nelson	TELEPHONE: (916) 956-5037
LICENSING EVALUATOR SIGNATURE:	DATE: 09/28/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2022

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: CKC CHILDREN'S CENTER	FACILITY NUMBER: 444408785
	VISIT DATE: 09/28/2022

NARRATIVE

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Indoor areas of the facility were inspected by the LPA today and observed to be clean, orderly, and safe for the day care children. Noel states that the facility is split into two rooms: two year olds and young three year olds & older three year olds and four year olds. LPA observed sufficient age-appropriate materials, toys, and play equipment on both sides the facility. The floors were clean and free of tripping hazards. Drinking water is readily available for children in the facility via water dispensers and water bottles from home labeled with the children’s names. At the facility, water bottles are washed daily and bedding for napping is washed weekly. Children’s bathrooms are clean, sanitary, and operable. There is a staff restroom located on the school campus that could be used by staff at the facility. There is an active waiver for an isolated bathroom and LPA observed the designated toilet that a child would use if ill was properly labeled. There is a working telephone in the facility.

The outdoor area of the facility was inspected and observed to be fenced in. The facility shares playground space with the school campus and has posted schedules indicating use by CKC and the school-aged children per waiver conditional requirements. Noel states that classrooms 1 & 13 share the playground space with CKC. LPA requested the facility submit waiver request for Sea Star Academy commingling and advised Noel on the required documents. LPA observed CKC's fenced outdoor area has play equipment that is in good condition, age-appropriate, and has sufficient resilient materials (tanbark) to absorb falls. No outdoor bodies of water were observed during today’s inspection. Shaded rest area is provided by canopy and there is a maintained sandbox located outside for children's use.

Food is provided by the facility and is stored, prepared, and served in a safe and healthful manner to the children. The facility offers both a full and half day program and provides lunch and AM/PM snack to children. All food for children is prepared and provided by the facility. Menu is in writing and posted at least one week in advance, accessible to authorized representatives. The kitchen and storage area is clean and free of litter and rubbish.

5 children’s files were reviewed during today’s inspection and all required documents were present including current Physicians Report (LIC701) and Immunization Record.

SUPERVISOR'S NAME: Joel Segura	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Cortney Nelson	TELEPHONE: (916) 956-5037
LICENSING EVALUATOR SIGNATURE:	DATE: 09/28/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2022

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: CKC CHILDREN'S CENTER	FACILITY NUMBER: 444408785
	VISIT DATE: 09/28/2022

NARRATIVE

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6 staff files were reviewed and most required documents were present including Mandated Reporter certificates and signed Employee Rights (LIC9052). There is at least one staff member present with current CPR/First-Aid that expires 4/2024. The Site Director, Tina Bucher, has current Mandated Reporter Training that expires on 11/16/2023. LPA reminded Noel that the Mandated Reporter Training must be renewed by all staff every 2 years.

The Executive Director understands that the Site Director shall be on the premises during the hours the center is in operation and that children at the center shall be visually supervised at all times. LPA reminded Noel 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, such as field trips.

Exit interview conducted and report was reviewed with the Executive Director, Noel Shermann.

As a result of today’s inspection, a deficiency was cited, see 809-D.

A NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 DAYS.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

SUPERVISOR'S NAME: Joel Segura	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Cortney Nelson	TELEPHONE: (916) 956-5037
LICENSING EVALUATOR SIGNATURE:	DATE: 09/28/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2022

LIC809 (FAS) - (06/04)

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