444415615-6-6-2021-07-CC-SCOS-C3QTEN-20210606144012

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 444415615
Report Date: 06/04/2021
Date Signed: 06/06/2021 03:01:02 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:	8314625437
CITY:	SANTA CRUZ	STATE: CA	ZIP CODE:	95060
CAPACITY:	10	CENSUS: 0	DATE:	06/04/2021
TYPE OF VISIT:	Case Management - Licensee Initiated	ANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Stephanie Simmons		TIME COMPLETED:	09:30 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 Analysts (LPA) Stephanie Collins conducted a site inspection of the facility and met with Director Stephanie Simmons. LPA identified herself and nature of the case management inspection. The inspection is in response to Licensee’s request for an increase in the capacity of their school age program from 10 to 16 School Age Children located in Room SA CA. A Fire Clearance has been granted on 05/27/2021. Due to technical issues this report was generating at the regional office and e-mailed to director. The facility’s pre-licensing Inspection for the School Age Program was completed on 09/29/2020 by the this LPA. LPA observed no structural changes to the facility in door or outside activity space. The School Aged Program- classroom is located on the bottom floor of the facility in a room identified as Room-SA- per fire clearance. The School Age Room was measured on 09/29/2121 during the Pre-licensing Facility Evaluation inspection to determine the maximum capacity that meets the requirement of 35 square feet of indoor activity space. No structural changes to the inside or outside of the facility were observed during todays inspection. 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.) = 906.47 sq. ft. Total School-Age Indoor Activity Space = (906.47 sq. ft.) divided by 35 = 25 Children

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Stephanie Collins	TELEPHONE: (408) 334-8555
LICENSING EVALUATOR SIGNATURE:	DATE: 06/04/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2021

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: 06/04/2021

NARRATIVE

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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 toilet and 1 sink. 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. Drinking water is arranged to be readily available to children.

The restrooms are located upstairs. A separate staff rest-room is located in the same area and is available to ill children . The director's office will serve as an isolation area for children who are ill. Isolation equipment (cots, chairs etc.) are available.
The SA- Room is furnished with age appropriate tables, chairs and play equipment.

Facility's request for an increase in capacity may be approved for 16 School Age Children pending Management's final review and approval.

No deficiencies were cited during today’s inspection.
NOTICE OF SITE VISIT WAS ISSUED AND MUST REMAIN POSTED FOR 30 DAYS.

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Stephanie Collins	TELEPHONE: (408) 334-8555
LICENSING EVALUATOR SIGNATURE:	DATE: 06/04/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2021

LIC809 (FAS) - (06/04)

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