444408896-2-16-2022-07-CC-CNEN-CBPUC3-20220216142715

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 444408896
Report Date: 02/16/2022
Date Signed: 02/16/2022 02:27:23 PM

Document Has Been Signed on 02/16/2022 02:27 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:	SALSIPUEDES STATE PRESCHOOL		FACILITY NUMBER:	444408896
ADMINISTRATOR:	CARMEN GUTIERREZ		FACILITY TYPE:	850
ADDRESS:	115 CASSERLY ROAD		TELEPHONE:	(831) 728-7812
CITY:	WATSONVILLE	STATE: CA	ZIP CODE:	95076
CAPACITY:	23	CENSUS: 6	DATE:	02/16/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:45 AM
MET WITH:	Carmen Gutierrez		TIME COMPLETED:	02:45 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 Site Supervisor, Carmen Gutierrez, for an unannounced Required- 1 Year Inspection. LPA was granted access to the facility by the Site Supervisor and toured both indoors and outdoors during the inspection. During the inspection, Lisa Sandoval and Vanessa Garcia, administrative representatives for Pajaro Valley Unified School District arrived and were present for the inspection. Hours of operation for the facility are Monday – Friday, 8:00AM-11:00AM & 11:45AM-2:45PM for AM and PM preschool programs. Upon arrival there were 3 staff (2 teachers and 1 assistant) present, which is compliant with the facility license capacity and ratio requirements. 6 children arrived to the facility for the afternoon preschool program at 11:45AM. LPA observed all required postings near the entrance to the facility. 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. LPA reviewed facility roster (LIC9040) and fire/disaster drill log during today’s inspection. The last fire/disaster drill was conducted on 1/26/2022 (PM program) and 1/24/2022 (AM program) which is compliant with the six-month requirement for facilities. LPA observed a fully charged 3A40BC fire extinguisher, functioning smoke detector and carbon monoxide detector. Site Supervisor states that she does not currently have any children in care who require Incidental Medical Services and does not administer medication at this time. The Site Director states that there are no weapons or firearms on the premises.

SUPERVISOR'S NAME: Joel Segura	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Cortney Nelson	TELEPHONE: (916) 956-5037
LICENSING EVALUATOR SIGNATURE:	DATE: 02/16/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/16/2022

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: SALSIPUEDES STATE PRESCHOOL	FACILITY NUMBER: 444408896
	VISIT DATE: 02/16/2022

NARRATIVE

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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

Indoor areas of the facility were inspected by the LPA today and observed to be clean, orderly, and safe for the day care children. LPA observed sufficient age-appropriate materials, toys, and play equipment in the facility. Furniture, such as tables, chairs, and shelves, are in good condition and safe for children. 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. Staff and children’s bathrooms are clean, sanitary, and operable. There is a working telephone in the facility.

The outdoor area of the facility was inspected and observed to be fenced in. 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 canopy. Sandbox is covered at the end of everyday with blue tarp. LPA advised Site Supervisor to rake sand in sandbox towards the edges to reduce possible tripping hazard for children. Outdoor sinks are located near the back door and 2 of the 3 are currently functioning. Site Supervisor states that she is planning to have the sink fixed soon.

6 children’s files and 3 staff files were reviewed during today’s inspection and all required documents were present. All staff members have current first-aid/CPR, Site Supervisor expires 1/22/2024, and current Mandated Reporter Training, Site Supervisor expires on 8/1/2025. LPA reminded Site Supervisor that the Mandated Reporter Training must be renewed by all staff every 2 years.

SUPERVISOR'S NAME: Joel Segura	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Cortney Nelson	TELEPHONE: (916) 956-5037
LICENSING EVALUATOR SIGNATURE:	DATE: 02/16/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/16/2022

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: SALSIPUEDES STATE PRESCHOOL	FACILITY NUMBER: 444408896
	VISIT DATE: 02/16/2022

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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 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.

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.

Exit interview conducted and report was reviewed with the Site Supervisor, Carmen Gutierrez and PVUSD Administrator, Vanessa Garcia.

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.

SUPERVISOR'S NAME: Joel Segura	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Cortney Nelson	TELEPHONE: (916) 956-5037
LICENSING EVALUATOR SIGNATURE:	DATE: 02/16/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/16/2022

LIC809 (FAS) - (06/04)

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