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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 270702033
Report Date: 06/13/2024
Date Signed: 07/03/2024 03:38:02 PM

Document Has Been Signed on 07/03/2024 03:38 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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:MELODYPARK CHRISTIAN DAYCARE SCHOOLFACILITY NUMBER:
270702033
ADMINISTRATOR/
DIRECTOR:		ANGIE CASTROFACILITY TYPE:
850
ADDRESS:1130 SAN VINCENTE AVENUETELEPHONE:
(831) 422-5311
CITY:SALINASSTATE: CAZIP CODE:
93901
CAPACITY: 111TOTAL ENROLLED CHILDREN: 111CENSUS: 30DATE:
06/13/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:11 AM
MET WITH:Angie CastroTIME VISIT/
INSPECTION COMPLETED:
01:50 PM
NARRATIVE
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Licensing Program Analyst (LPA) Andrea Cortez and Licensing Program Manager (LPM) Gladys Kuizon met with Angie Castro Director, for an unannounced Annual/Random inspection. LPA and LPM toured the indoor and outdoor areas of the Facility with Angie during today's inspection. LPA and LPM 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), Menus, and Activity Schedule. Days and hours of operation are Monday through Friday 7:00AM to 5:30PM. The Facility is licensed to serve a maximum capacity of 111 children ages two to six years old. LPA toured 7 classrooms. Only rooms 2,7,11, and 12 are currently in use due to summer hours of operation. All rooms were observed in ratio.

LPA reviewed 6 children's and 4 staff files during today's inspection. Each child's file reviewed contains the required forms; including the Information and Emergency Information form (LIC 700). 2 out of 4 staff files reviewed did not have immunization records. All staff files reviewed contained transcripts/verification of experience and Health Screening Report. All staff have current certificates of completion of the Mandated Reporter Training for Child Care Workers on file. Teachers have current CPR and First Aid certifications on file. Angie 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 (field trips). Facility does not provide transportation.

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SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Andrea Cortez
LICENSING EVALUATOR SIGNATURE: DATE: 06/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/13/2024
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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: MELODYPARK CHRISTIAN DAYCARE SCHOOL
FACILITY NUMBER: 270702033
VISIT DATE: 06/13/2024
NARRATIVE
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 LPA observed the following teacher to child ratio: Room 2 (1:9), Room 7 (1:9), Room 11 (1:8), Room 12 (1:8)

LPA observed Facility trash cans covered, no odor, kitchen food prep area clear of pests, and bathrooms in good working order with sanitary supplies available for use. Facility has a third-party cleaning service that cleans the Facility Monday through Friday in the evenings. LPA observed furniture and equipment is in good condition and age appropriate. LPA observed drinking water in individual water bottles. No weapons or firearms on the premises. The Facility has functioning carbon monoxide detectors and fire alarm system.

The Facility provides snacks. June’s menu calendar is posted. No accessible toxic or poisonous materials were observed. LPA observed First Aid kits and fire extinguisher in the Facility.



The Facility does not administer any medication 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

The playground area utilized by children is surrounded by appropriate fencing and the outdoor surfaces are safe for the children. LPA observed that the outdoor equipment is age appropriate and in good condition. There is adequate equipment, supplies, and toys for children outdoors. Play structures are surrounded with bark material to absorb falls. Shade is provided by trees. LPA did not observe any bodies of water during today's inspection.
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SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Andrea Cortez
LICENSING EVALUATOR SIGNATURE:

DATE: 06/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/13/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 07/03/2024 03:38 PM - It Cannot Be Edited


Created By: Andrea Cortez On 06/13/2024 at 12:24 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: MELODYPARK CHRISTIAN DAYCARE SCHOOL
FACILITY NUMBER: 270702033

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/13/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
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
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Based on record review, the licensee did not comply with the section cited above in 2 out of 4 staff (S1-S2) missing immunization records which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/13/2024
Plan of Correction
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Licensee to submitt proof of required immunization for S1 and S2 by POC due date.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Gladys Kuizon
LICENSING EVALUATOR NAME:Andrea Cortez
LICENSING EVALUATOR SIGNATURE:
DATE: 06/13/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/13/2024


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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: MELODYPARK CHRISTIAN DAYCARE SCHOOL
FACILITY NUMBER: 270702033
VISIT DATE: 06/13/2024
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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.

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 Director. Deficiencies issued during today's inspection.

A notice of site visit was given and must remain posted for 30 days.

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Andrea Cortez
LICENSING EVALUATOR SIGNATURE:

DATE: 06/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/13/2024
LIC809 (FAS) - (06/04)
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