444408832-12-2-2022-07-CC-CNEN-CLQQWN-20221202113212

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 444408832
Report Date: 12/02/2022
Date Signed: 12/02/2022 11:32:36 AM

Document Has Been Signed on 12/02/2022 11:32 AM - 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:	CALABASAS STATE PRESCHOOL		FACILITY NUMBER:	444408832
ADMINISTRATOR:	LATHROP/E.PEREZ		FACILITY TYPE:	850
ADDRESS:	202 CALABASAS ROAD		TELEPHONE:	(831) 728-6368
CITY:	WATSONVILLE	STATE: CA	ZIP CODE:	95076
CAPACITY:	24	CENSUS: 15	DATE:	12/02/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:20 AM
MET WITH:	Ema Perez & Antonette Recinos		TIME COMPLETED:	11:45 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 Analyst (LPA), Cortney Nelson, met with Site Supervisor, Ema Perez, and Pajaro Valley Unified School District Representative, Antonette Recinos, for an unannounced Required- 1 Year Inspection. The preschool is located on the campus of Calabasas Elementary School in Room 1. LPA was granted access to the facility by the Site Supervisor and toured both indoors and outdoors during the inspection. Upon arrival, there were 15 preschool-age children, 2 teachers, and Site Supervisor present, which is compliant with the facility license capacity and Title 5 ratio requirements. LPA observed all required postings near the entrance to the facility and the hours of operation are Monday – Friday, 8:30AM-11:30AM & 12:15PM-3:15PM (half day preschool program). 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 with full legal signature and time of day. The last fire/disaster drill was conducted on 11/8/2022, which is compliant with the six-month requirement for facilities. LPA observed fully charged 3A40BC & 2A10BC fire extinguishers (last serviced: 9/2022) and functioning carbon monoxide detector. The facility has built in fire detection system. The Site Supervisor states that she does currently have children in care who require Incidental Medical Services and does administer medication at this time. LPA observed that medication is properly stored out of reach of children, in a locked box, with the proper documentation. LPA advised Site Supervisor that storage container for emergency medication, such as EpiPens or Inhalers, does not need to be in a locked container, but should be inaccessible to children. The Site Supervisor states that there are no weapons or firearms on the premises. This facility provides Incidental Medical Services- IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual- Regulation Interpretations and Procedures for Child Care Centers, Section 101173 and 101226. 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: 12/02/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2022

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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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: CALABASAS STATE PRESCHOOL	FACILITY NUMBER: 444408832
	VISIT DATE: 12/02/2022

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. During today's inspection, LPA observed the children engaged in circle time singing songs and in small groups playing with play-doh. LPA observed sufficient age-appropriate materials, toys, and play equipment in 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 disposable cups. The staff and children’s bathrooms are clean, sanitary, and operable. There is a separate staff bathroom, not utilized by the children, which an isolated child can use if necessary. There is a working telephone in the facility.

The outdoor area of the facility was inspected and observed to be fenced in. There is a playground and tables with small activities, such as puzzles and crafts, for the children to engage with outside. There are two (2) functioning sinks and a drinking fountain located outside. LPA observed play equipment was 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 building overhang, table umbrellas, and large trees located outside.

Food is provided by Pajaro Valley Unified School District food program and is served in a safe and healthful manner to the children. The facility offers a half day program and provides AM/PM snack to the children. A monthly snack menu is in writing and posted at least one week in advance, accessible to authorized representatives.

Five (5) children’s files were reviewed during today’s inspection and all required documents were present. Three (3) staff files were reviewed and all required documents were present. Criminal Record clearance is obtained through the school district. All staff members present have current CPR/First-Aid and the Site Supervisor's expires 1/22/2024. All staff members have current Mandated Reporter Training and the Site Supervisors expires on 8/18/2024. LPA reminded Site Supervisor that the Mandated Reporter Training must be renewed by all staff every 2 years.

The Site Supervisor was reminded that all adults 18 and over, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

SUPERVISOR'S NAME: Joel Segura	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Cortney Nelson	TELEPHONE: (916) 956-5037
LICENSING EVALUATOR SIGNATURE:	DATE: 12/02/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2022

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: CALABASAS STATE PRESCHOOL	FACILITY NUMBER: 444408832
	VISIT DATE: 12/02/2022

NARRATIVE

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The Site Supervisor understands that she 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 the Site Supervisor 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.

LPA advised the facility of water lead testing requirement for Child Care Centers, due by January 1, 2023 and advised that preschools located on school campuses are still required to complete the testing.

Exit interview conducted and report was reviewed with the Pajaro Valley Unified School District Representative, Antonette Recinos.

As a result of today’s inspection, no deficiencies were cited.

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: 12/02/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2022

LIC809 (FAS) - (06/04)

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