270700474-3-4-2024-07-CC-ELAS-D332VN-20240304164413

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 270700474
Report Date: 03/04/2024
Date Signed: 03/04/2024 04:44:20 PM

Document Has Been Signed on 03/04/2024 04:44 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:	NORTHMINSTER PRESBYTERIAN PRESCHOOL/KINDERPREP		FACILITY NUMBER:	270700474
ADMINISTRATOR:	JERRIANNA HAGIO		FACILITY TYPE:	850
ADDRESS:	315 EAST ALVIN DRIVE		TELEPHONE:	(831) 449-5676
CITY:	SALINAS	STATE: CA	ZIP CODE:	93906
CAPACITY:	72	CENSUS: 34	DATE:	03/04/2024
TYPE OF VISIT:	Case Management - Annual Continuation	UNANNOUNCED	TIME BEGAN:	09:35 AM
MET WITH:	Jerrianna Hagio		TIME COMPLETED:	03:45 PM

NARRATIVE

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Licensing Program Analyst (LPA) Elizabeth Larios conducted an unannounced Case Management - Annual Continuation Inspection. The purpose of today’s visit is to ensure the facility is in compliance with Title 22 California Code of Regulations. LPA met with the Director Jerrianna Hagio, and explained the nature of today's visit. LPA toured the facility both inside and outside during todays visit. LPA observed the required posted materials, including the Facility License, Emergency Disaster Plan (LIC 610), Earthquake Preparedness Checklist (LIC 9148), Parents' Rights Poster (PUB 393), Personal Rights (LIC 613A), Child Car Seat Law (PUB 269), and activity schedule in each classroom. The hours of operation are Monday - Friday, 7:00am - 5:30pm.

LPA reviewed staff files during today's visit. All staff have fingerprint clearances. Staff has current CPR and First Aid certifications on file. Staff have Health Screening Report and TB test, Immunization (Measles, Pertussis, and Flu) record and required Training. Staff had current Mandated Reporter Training certificate in file. Director understands 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.

Director understands the conditions, limitations, and capacity specifications of the facility license. Director understands that children shall be visually supervised at all times. LPA observed classroom in order. Drinking water is readily available for the children in each room and in the outdoor playground area via water dispensers/water filter cups and individualized water bottles. LPA observed solid waste containers with tight-fitting lids in each room. Staff and children's bathrooms are clean, sanitary. There is a separate staff bathrooms not utilized by the children which an isolated child can use if needed. Director states that there are no weapons or firearms on the premises.

====CONTINUE IN LIC 809-C====

SUPERVISOR'S NAME: Joel Segura	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Elizabeth Larios	TELEPHONE: (408) 497-9236
LICENSING EVALUATOR SIGNATURE:	DATE: 03/04/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2024

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: NORTHMINSTER PRESBYTERIAN PRESCHOOL/KINDERPREP	FACILITY NUMBER: 270700474
	VISIT DATE: 03/04/2024

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LPA observed furniture and equipment were not in good condition and safe for the children. The playground areas utilized by children is surrounded by appropriate fencing. LPA did not observed sufficient resilient materials under slides and other similar equipment, and surrounded area that should be cushioned with material that absorbs falls. LPA observed that the outdoor equipment is age appropriate. LPA did not observe any bodies of water.

The facility only provides package snacks and beverages (milk, juice, and water) and children bring there lunch from home. Food storage such refrigerator,and microwave areas are clean, free of litter & rubbish, and free of rodents and other vermin. LPA observed a fully charged 3A40BC/2A10BC fire extinguishers in each classroom, and working smoke/carbon monoxide detectors and first aid kits. Director states that the facility does not administer medications at this time.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 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 (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

Director 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.

Exit interview conducted and report was reviewed with the Director Jerrianna Hagio. Deficiencies issued during today's inspection and appeal rights were given.

A NOTICE OF SITE VISIT WAS ISSUED, POSTED NEAR THE ENTRANCE TO THE FACILITY, AND MUST REMAIN POSTED FOR 30 DAYS.

SUPERVISOR'S NAME: Joel Segura	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Elizabeth Larios	TELEPHONE: (408) 497-9236
LICENSING EVALUATOR SIGNATURE:	DATE: 03/04/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2024

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 03/04/2024 04:44 PM - It Cannot Be Edited

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: NORTHMINSTER PRESBYTERIAN PRESCHOOL/KINDERPREP	FACILITY NUMBER: 270700474
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/04/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.954

Licensure Requirements

Every licensed child day care center shall have one or more carbon monoxide detectors in the facility that meet the standards established in Chapter 8 (commencing with Section 13260) of Part 2 of Division 12. The department shall account for the presence of these detectors during inspections. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, the licensee did not comply with the section cited above in which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 03/11/2024
	Plan of Correction
1 2 3 4	Licensee will purchase a carbon monoxide detector for both classrooms by POC date 3/11/2024 and provide proof by emailing a picture of it to the department.

Type B

Section Cited

HSC

1597.16(a)(1)

Lead Testing

(1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on interview and record review, the licensee did not comply with the section cited above as the facility has not completed water lead testing or submitted water lead test results that follow the written directives, which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 03/11/2024
	Plan of Correction
1 2 3 4	Licensee will have the Lead Water test completed/submitted to department or scheduled by POC date 3/11/2024.

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Joel Segura	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Elizabeth Larios	TELEPHONE: (408) 497-9236
LICENSING EVALUATOR SIGNATURE:	DATE: 03/04/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2024

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 03/04/2024 04:44 PM - It Cannot Be Edited

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: NORTHMINSTER PRESBYTERIAN PRESCHOOL/KINDERPREP	FACILITY NUMBER: 270700474
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/04/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101238(a)

Buildings and Grounds

(a) The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, the licensee did not comply with the section cited above during indoor and outdoor inspection LPA observed a exit door that leads to playground to have a broken door nob hard to close, a crack toy chair, rusted/broken seesaw, rip children sofa, and outside area has a tree near picnic tables that has roots sticking out of ground and is a tripping hazard in which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 03/11/2024
	Plan of Correction
1 2 3 4	Licensee will submit pictures to department as proof repairs were completed. Licensee will submit a written plan by POC date 3/11/2024 indicating how they will keep the child care center clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors.

Type B

Section Cited

CCR

101238(g)

Buildings and Grounds

(g) Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to children shall be stored where inaccessible to children. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation during tour of facility it was observed in preschool classroom unlock closet that has cleaning supplies, unlock cabinet under children sink had a hammer, nails, and air freshener refill, cabient under preschool bathroom had a hairspray, the licensee did not comply with the section cited above in which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 03/11/2024
	Plan of Correction
1 2 3 4	Director and staff immediately removed items found under sinks, locked closet door with cleaning supplies, and made items inaccesible to children. Corrected during visit.

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Joel Segura	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Elizabeth Larios	TELEPHONE: (408) 497-9236
LICENSING EVALUATOR SIGNATURE:	DATE: 03/04/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2024

LIC809 (FAS) - (06/04)

Page: 4 of 5

Document Has Been Signed on 03/04/2024 04:44 PM - It Cannot Be Edited

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: NORTHMINSTER PRESBYTERIAN PRESCHOOL/KINDERPREP	FACILITY NUMBER: 270700474
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/04/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101238.2(e)

Outdoor Activity Space

(e) As a condition of licensure, the areas around and under high climbing equipment, swings, slides and other similar equipment shall be cushioned with material that absorbs falls. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, the licensee did not comply with the section cited above insufficient resilient materials under slides and other similar equipment, and surrounded area that should be cushioned with material that absorbs falls in which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 03/11/2024
	Plan of Correction
1 2 3 4	Licensee will order additional resilient material for the playground and ensure that the ground is not visible. Resilient materials should be maintained around the playground. Photographs of additional resilient material should be submitted to the department by POC date 3/11/2024.

Type B

Section Cited

HSC

1596.7995(a)(1)

General Provisions and Definitions

(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, and record review, the licensee did not comply with the section cited above for two staff (S4 and S5 no immunization records) and staff (S1-S6 no influenza record) which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 03/11/2024
	Plan of Correction
1 2 3 4	Licensee will submit proof of immunizations for measles, pertussis and influenza for staff (S4-S5) and proof of immunization for influenza or statement declining influenza for staff (S1-S6), by POC date of 03/11/2024.

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Joel Segura	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Elizabeth Larios	TELEPHONE: (408) 497-9236
LICENSING EVALUATOR SIGNATURE:	DATE: 03/04/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2024

LIC809 (FAS) - (06/04)

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