444408785-5-14-2024-07-CC-CNEN-D59QR3-20240514122316

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 444408785
Report Date: 05/14/2024
Date Signed: 05/14/2024 12:23:24 PM

Document Has Been Signed on 05/14/2024 12:23 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/ DIRECTOR:	TINA BURCHER		FACILITY TYPE:	850
ADDRESS:	8005 WINKLE AVENUE		TELEPHONE:	(831) 475-6587
CITY:	SANTA CRUZ	STATE: CA	ZIP CODE:	95065
CAPACITY: 42	TOTAL ENROLLED CHILDREN: 35	CENSUS: 27	DATE:	05/14/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:15 AM
MET WITH:	Nidya Juarez		TIME VISIT/ INSPECTION COMPLETED:	12:33 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 Preschool Program Director, Nidya Juarez, for an unannounced Annual/Random Inspection. LPA was granted access to the facility by Nidya and toured both indoors and outdoors during the inspection. Upon arrival, there were twenty seven (27) preschool-age children and six (6) staff present, which is compliant with the facility license capacity and ratio requirements. There were seventeen (17) children present in the butterflies classroom (ages 3-5 yrs) and ten (10) in the caterpillar classroom (2-3 yrs old). LPA observed all required postings near the entrance to the facility and the hours of operation are Monday – Friday, 7:30AM-5:30PM. 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 digitally using Brightwheel with full legal signature and time of day. The last fire/disaster drill was conducted on 4/22/2024, which is compliant with the six-month requirement for facilities. LPA observed two (2) fully charged 3A40BC fire extinguishers (last serviced: 11/2023), functioning smoke detector and carbon monoxide detector. Nidya states that she does not currently have any children in care who require Incidental Medical Services and does not administer medication at this time. There are no weapons or firearms on the premises. LPA reminded that the minimum indoor temperature for a child care center shall be 68 degrees F and maximum of 85 degrees F. Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

Joel Segura
Cortney Nelson
	DATE: 05/14/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2024

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: CKC CHILDREN'S CENTER	FACILITY NUMBER: 444408785
	VISIT DATE: 05/14/2024

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. During today's inspection, LPA observed children engaged in circle time, water color painting, and other small games/activities. There is sufficient age-appropriate materials, toys, and play equipment in the facility. The floors are clean and free of tripping hazards. Drinking water is readily available for children via Brita water dispensers and water bottles from home labeled with the children’s names. The children’s bathrooms are clean, sanitary, and operable. There is a working telephone in the facility.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for
drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. The facility was constructed in 2017 and submitted proof of exemption for water lead testing which was received 12/2022.

The outdoor area of the facility was inspected and observed to be fenced in. There are two play areas for both classrooms and are equipped with outdoor play equipment such as a playground, plastic play structures, sandboxes, and riding bikes. LPA observed play equipment was in good condition, age-appropriate, and has sufficient resilient materials (rubber padding/tanbark) to absorb falls. No outdoor bodies of water were observed during today’s inspection. Shaded rest area is provided by canopy and building overhang.

The facility offers a full day program and provides AM/PM snack and lunch to children. The 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. Equipment necessary for the storage, preparation and service of food is well maintained, clean, and sanitized after each use.

Five (5) children’s files were reviewed and most documents were present. LPA reminded that a signed copy of the Acknowledgment of Receipt of Licensing Report (LIC9224) shall be maintained in a child's file and shall be completed for 12 months following a type A citation.

Five (5) staff files were reviewed and most required documents were present. There is at least one staff member present with current CPR/First-Aid that expires 4/1/2025. LPA reminded that the Mandated Reporter Training must be renewed by all staff every 2 years and shall be completed for Child Care Providers (AB1207).

SUPERVISOR'S NAME: Joel Segura
LICENSING EVALUATOR NAME: Cortney Nelson
LICENSING EVALUATOR SIGNATURE:	DATE: 05/14/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2024

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: 05/14/2024

NARRATIVE

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The facility has a waiver for centralized criminal record clearance and exemptions for staff and all are associated to Westlake CKC (#440710576). All staff present today were associated and have clearance.

Licensee was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Nidya 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 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 Preschool Program Director, Nidya Juarez.

As a result of today’s inspection, deficiencies were cited, see LIC809-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 may 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 CARE tools, please send email inquiries 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/inspection-process.

SUPERVISOR'S NAME: Joel Segura
LICENSING EVALUATOR NAME: Cortney Nelson
LICENSING EVALUATOR SIGNATURE:	DATE: 05/14/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2024

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 05/14/2024 12:23 PM - It Cannot Be Edited

Created By: Cortney Nelson On 05/14/2024 at 11:50 AM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 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: 05/14/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.7995(a)(1)

General Provisions and Definitions

(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on interview and record review, the licensee did not comply with the section cited above as one staff member did not have proof of immunity to measles or pertussis, which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 05/31/2024
	Plan of Correction
1 2 3 4	The Licensee shall submit proof of immunity to measles and pertussis for one staff member (S5) to the Department by 5/31/2024. LPA advised that a blood panel may be completed to demonstrate immunity.

Type B

Section Cited

HSC

1596.8595(c)(4)

1596.8595 Posting licensing report by child care facility or home; duration of posting; civil penalty for failure to comply; reports to be provided to parents or guardians of each child receiving service (c)(1) A licensed child day care facility shall provide to the parents or guardians of each child receiving services in the facility copies of any licensing report that documents any Type A citation that represents an immediate risk to the health, safety, or personal rights of children in care...(4) The licensee shall keep verification of receipt in each child's file. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on interview and record review, the licensee did not comply with the section cited above as two (2) out of five (5) children's files did not have verification of receipt (LIC9224), which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 05/17/2024
	Plan of Correction
1 2 3 4	The Licensee shall provide copy of the report that indicates a Type A citation to the parent/guardian and obtain verification of receipt (LIC9224) for two children who did not have a copy in their file. A copy of the signed LIC9224 shall be submitted to the Department by 5/17/2024.

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

LICENSING EVALUATOR NAME:

Cortney Nelson

LICENSING EVALUATOR SIGNATURE:

DATE: 05/14/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2024

LIC809 (FAS) - (06/04)

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