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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 444414586
Report Date: 10/09/2019
Date Signed: 10/09/2019 01:17:51 PM

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:SEEDS OF KNOWLEDGE PRE-SCHOOLFACILITY NUMBER:
444414586
ADMINISTRATOR:ELISABETH CLARKFACILITY TYPE:
850
ADDRESS:16900 HIGHWAY 9TELEPHONE:
(831) 251-5711
CITY:BOULDER CREEKSTATE: CAZIP CODE:
95006
CAPACITY:45CENSUS: 18DATE:
10/09/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Terri Robinson TIME COMPLETED:
01:30 PM
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Licensing Program Analyst (LPA) Zaid Hakim conducted an Unannounced Annual / Random Inspection at the facility today. Upon arrival, LPA observed eighteen (18) preschool age children and at least four (4) staff engaging in daily activities and met with Ms. Terri Robinson, Director. LPA toured the facility inside and out and observed required postings including but not limited to; the License to Operate, Emergency disaster plan (LIC 610) and Notification of Parents Rights (PUB 393). Days and hours of operation are Monday through Friday 7:00am to 06:00pm. The facility is licensed to serve a maximum of eighty four (45) children ages two (2) years old to entry to First grade in classrooms K1 and K2 only. During the inspection, LPA observed children to be supervised and attended to and the facility to be within ratio requirements. The facility operates on active school campus. During the inspection LPA and the Director reviewed mailing addresses for facility business and discussed payment of licensing fees in detail. The Director understands that Licensing fees are due each year. LPA and the Director also discussed early closure today and potential closures during this week due to the PGE power shutoff. Director has agreed to submit an LIC 624 Unusual Incident Report to Community Care Licensing should the situation require so.

LPA observed that the facility is operating within the terms of the license and is in compliance with the approved fire clearance capacity. The facility was toured inside and out and was observed to be clean, safe, sanitary, and in good repair. Disinfectants, cleaning solutions, and all other items that are dangerous to children were observed to be securely stored, locked, and inaccessible. LPA advised that non-toxic supplies should be inaccessible to children as directed by the manufacturer of the product. Restrooms are located outside of the classrooms and were observed to be clean and functional. Indoor and outdoor activity spaces were observed as properly equipped with age appropriate toys and supplies that are in safe condition. Storage containers for waste have tight fitting covers and floors and carpeting are free from hazard and obstruction. LPA observed that the facility has posted menus throughout the facility that are consistent with food supplies. The facility provides snacks and meals and parents are informed of what foods may be served at any given time prior to being served. Children also have the option to bring food from home and the Director stated staff will assist with refrigeration and warming when needed. The Director stated that all staff are aware of food allergies or dietary restrictions, which are outlined in children's files. LPA discussed staff protocols upon serving food such as; visual observation of all foods and maintaining appropriate temperatures prior to serving. LPA and the Director discussed children's personal rights and napping / rest time at the facility. Children may be allowed to engage in a stationary activity or quiet rest time instead of napping should they prefer it. The Director understands that mats for napping should be arranged with sufficient space for a walkway. LPA observed that linens used by children are stored not touching and washed regularly

The Director has been referred to the department website for Licensing resource and updates: http://www.cdss.ca.gov/inforesources/Child-Care-Licensing

REPORT CONTINUED ON THE FOLLOWING PAGE (PAGE #2 - REPORT DATED 10/09/2019):
SUPERVISOR'S NAME: Anthony StudebakerTELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Zaid HakimTELEPHONE: (408) 497-9236
LICENSING EVALUATOR SIGNATURE:

DATE: 10/09/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 3
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: SEEDS OF KNOWLEDGE PRE-SCHOOL
FACILITY NUMBER: 444414586
VISIT DATE: 10/09/2019
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CONTINUATION OF PREVIOUS PAGE (PAGE #1 - REPORT DATED 10/09/2019):

LPA observed doors, locks, and barricade gates securing off limit areas. No weapons are stored on site and no bodies of water are on the premises. LPA observed fire extinguishers, smoke detectors, carbon monoxide detectors, and complete first aid kits throughout the facility. Emergency disaster drills are performed as required, last of which was done in 09/2019. The last fire safety inspection conducted by the local fire authority was conducted in 6-7/2019 in which detectors, alarm systems, and fire extinguishers were serviced. LPA reminded the Director that all fire safety items and equipment should be maintained at least every 12 months including, fire extinguishers and all detectors. LPA reviewed a random sample of children's records and observed that there is a separate, complete, and current record for each child enrolled in the center. LPA observed that each child record reviewed maintained a valid health screening report, required immunization records, and emergency contact information.

The facility maintains a written sign in and out sheet, that is updated throughout the day, containing full signatures from responsible parties. The facility maintains an updated roster of children enrolled in the program. A random sample of administration and staff records were reviewed. LPA reminded the Director that staff files are to maintain complete immunization and TB test result records at all times, after the 30 day period after starting work. LPA reviewed a random sample of teacher files and observed at least one staff on site maintains valid CPR / First aid certification which expires in 09/2021. The Director stated that she is aware that there must be at least one staff with current CPR/ First Aid training at all times. LPA toured the outdoor play area, which was observed to be safe and equipped with age appropriate toys and equipment. There is secure perimeter fencing around the outdoor play areas and play structures and equipment appeared to be in safe condition. LPA observed that there is sufficient absorbent materials under structures, drinking water available for children via pitchers and cups, and sufficient covering for shade provided by the building overhang, canopies, and trees. LPA and the Director discussed transition protocol, including direct supervision of children at all times. LPA and the Director discussed children staying hydrated in hot weather, weather conditions such as extreme heat and air quality, the facility outdoor supervision and staff rotation plan for supervision and safety outside, and being aware of weather conditions that affect program operation such as air quality.

The facility does not provide transportation to children and the program does not include off site field trips. LPA and the Director discussed parent permission and supervision away from the facility premises. The facility currently does not have any children enrolled that require assistance with medications. LPA and the Director discussed emergency disaster drills and preparedness, emergency lock-down procedures, children's personal rights including no corporal punishment, positive forms of discipline, and staffing qualifications / educational units in the core subject areas: Child Development, Family Child Community, and Program + Curriculum.

REPORT CONTINUED ON THE FOLLOWING PAGE (PAGE #3 - REPORT DATED 10/09/2019):
SUPERVISOR'S NAME: Anthony StudebakerTELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Zaid HakimTELEPHONE: (408) 497-9236
LICENSING EVALUATOR SIGNATURE:

DATE: 10/09/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2019
LIC809 (FAS) - (06/04)
Page: 2 of 3
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: SEEDS OF KNOWLEDGE PRE-SCHOOL
FACILITY NUMBER: 444414586
VISIT DATE: 10/09/2019
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CONTINUATION OF PREVIOUS PAGE (PAGE #2 - REPORT DATED 10/09/2019):

LPA reminded Licensee 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.

LPA reminded the Director of the immunization requirement regarding Senate Bill 792 (pertussis, measles, and flu vaccines) for ALL STAFF THAT WORK DIRECTLY WITH CHILDREN and the required "Mandated Reporter" training that all staff will be required to complete starting January 1, 2018 per AB 1207.
https://mandatedreporterca.com/
*LPA reminded the Director that new staff have 90 days to complete the Required Mandated Reporter Training and in the event of being issued a citation, the Director will have 45 days to ensure staff complete the training.

LPA and the Director also discussed applicable updates to this training regarding length and material and the renewal period of every 2 years. LPA provided additional written information on Mandated Reporter Training, Active Shooter Information, Effects of Lead Exposure, and Safe Sleep for Infants.

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 Family Child Care Homes Section 102417. 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 Notice of Site Visit has been issued and must remain posted for 30 consecutive days.

No Deficiencies have been cited during today's inspection.
Exit interview conducted with Ms. Terri Robinson, Director.
SUPERVISOR'S NAME: Anthony StudebakerTELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Zaid HakimTELEPHONE: (408) 497-9236
LICENSING EVALUATOR SIGNATURE:

DATE: 10/09/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2019
LIC809 (FAS) - (06/04)
Page: 3 of 3