444415615-3-16-2021-07-CC-SCOS-BZ6R6J-20210316124449

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 444415615
Report Date: 09/29/2020
Date Signed: 03/16/2021 12:45:00 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:	COASTAL COMMUNITY PRESCHOOL		FACILITY NUMBER:	444415615
ADMINISTRATOR:	STEPHANIE SIMMONS		FACILITY TYPE:	840
ADDRESS:	900 HIGH STREET		TELEPHONE:	(831) 462-5437
CITY:	SANTA CRUZ	STATE: CA	ZIP CODE:	95060
CAPACITY:	58	CENSUS: 0	DATE:	09/29/2020
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Stephanie Simmons & Kimberlee		TIME COMPLETED:	09:54 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) Stephanie Collins conducted a scheduled Tele-Pre-Licensing inspection via video conference call with Center Director Stephanie Simmons and Administrative Director Kimberlee Biagini . Applicant's Representatives were informed that due to the COVID-19 situation and "Shelter in Place" Order, this LIC809 Facility Evaluation Report will be generated at the Licensing Office and emailed to the facility. Facility’s reply to the email will serve as acknowledgement that the report was received. Applicant is applying for a License to operate a school-age program with a capacity of 10 school age children 5-8 years old at 900 High Street Santa Cruz, CA. 95060. A Fire Clearance has been granted on 09/8/20. The school-age program will operate Monday through Friday from 08;00AM to 05:00PM, serving children 5-8 years of age. Facility's phone # (831)462-5437. Facility also has a Preschool Center (License #444408854 ) located at the same address. The School Aged Program- classroom is located on the bottom floor of the facility in a room identified as Room- SA-CA (New Room per fire clearance) The new room was measured to determine the maximum capacity that meets the requirement of 35 square feet of indoor activity space. The following measurements were taken by Director Stephanie Simmons and Administrative Director Kimberlee Biagini as LPA observed the process and provided direction over the video call. Ppg. 1

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Stephanie Collins	TELEPHONE: (408) 334-8555
LICENSING EVALUATOR SIGNATURE:	DATE: 09/29/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/29/2020

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: COASTAL COMMUNITY PRESCHOOL	FACILITY NUMBER: 444415615
	VISIT DATE: 09/29/2020

NARRATIVE

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Continuation Ppg 2.
School-Age Indoor Activity Space:
Measurement was taken 09/29/2020
New Room = (Total sq. ft. of Room 1) – (Total Encumbered Space in Room 1)
= (926.89 sq. ft.) – (20.42 sq. ft.)
= 906.47sq. ft.
Total School-Age Indoor Activity Space = (906.47 sq. ft.) divided by 35
= 25 Children

School-Age Outdoor Playground Space:
The measurements were taken 06/22/07
Total Outdoor Activity Area = (3558.197 sq. ft.)
(3558.197 sq. ft). divided by 75
= 47 Children

School-age children will use a designated restroom upstairs , which has 1 toilets and 1 sinks. Hand soap and disposable paper towels are available inside the restroom. The school-age program will utilize the playground as well as participate in supervised nature walkers. the playground is enclosed with fencing. The outdoor activity space is equipped with age-appropriate equipment such as a wooden play structure. Areas around and under climbing equipment have wood-chips as material that absorbs falls. Shade is provided by building overhang and canopy. Drinking water is arranged to be readily available to children.

The restrooms near the director's office are designated for staff and children who become ill to use. The director's office will serve as an isolation area for children who are ill and has equipment (cots, chairs etc.) available. There are cubby holes/hooks for children to store their belongings. The new room (SA-CA) is furnished with age appropriate tables and chairs and play equipment.

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Stephanie Collins	TELEPHONE: (408) 334-8555
LICENSING EVALUATOR SIGNATURE:	DATE: 09/29/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/29/2020

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: COASTAL COMMUNITY PRESCHOOL	FACILITY NUMBER: 444415615
	VISIT DATE: 09/29/2020

NARRATIVE

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Ppg 3
school-age program request school age children bring their own snacks. Snacks can be provided if necessary. The kitchen is equipped with a refrigerator and microwave to store and heat food as needed. There are trash cans with tight fitted lids, and paper towels available.
Facility staff will clean and disinfect equipment daily with wipes and solutions. Detergents, cleaning compounds, sharps, medicines, and other items which could pose a danger if readily available to children are stored where they are inaccessible to children. Storage/Maintenance rooms will be locked locked.

Director Stephanie Simmons and Administrator Director Kimberlee Biagini have both obtained a Clearance for Criminal Background and Child Abuse Index Checks. Stephanie Simmons meets the education and experience qualification requirement to be the Director of a school-age Center. She has a current CPR /1st Aid Certification . Director has proof of immunity against Measles and Pertussis, and Health Screening with Tuberculosis clearance.

Director is reminded of the applicable civil penalties for those adults who have not received fingerprint clearances, are not associated to the facility, and who come in contact with or provide care and supervision to the children. For an initial violation, civil penalty amounts to $100.00 per person per day up to $500.00 per person. For a subsequent violation within a 12-month period, civil penalty amounts to $100.00 per person up to $3000.00 per person.

If the facility plans to provide Incidental Medical Services – IMS. A Plan of Operation that includes IMS has will 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)/ (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: Sandy Knight	TELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Stephanie Collins	TELEPHONE: (408) 334-8555
LICENSING EVALUATOR SIGNATURE:	DATE: 09/29/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/29/2020

LIC809 (FAS) - (06/04)

Page: 3 of 4

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: COASTAL COMMUNITY PRESCHOOL	FACILITY NUMBER: 444415615
	VISIT DATE: 09/29/2020

NARRATIVE

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Ppg 4
Facility is encouraged to frequent the Department’s website at www.cdss.ca.gov [Shortcut: www.ccld.ca.gov] to access resources for Providers, Regulations, Annual License fee, Adoption of new Laws, etc.

Director Stephanie Simmons and Kimberlee Biagini were informed of the required documents that are missing via e-mail and tele-conference call. Upon receipt and review of the remaining documents, the application file will be submitted to Licensing Management for the final stage of review and approval.

Exit Interview was conducted, where this report was e-mailed to directors.

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Stephanie Collins	TELEPHONE: (408) 334-8555
LICENSING EVALUATOR SIGNATURE:	DATE: 09/29/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/29/2000

LIC809 (FAS) - (06/04)

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