274416218-9-9-2021-07-CC-SCES-C6PQNJ-20210909121912

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 274416218
Report Date: 09/09/2021
Date Signed: 09/09/2021 12:19:17 PM

Document Has Been Signed on 09/09/2021 12:19 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:	SAN ARDO EARLY EDUCATION & CHILD CARE CENTER		FACILITY NUMBER:	274416218
ADMINISTRATOR:	GUADALUPE LAZO		FACILITY TYPE:	850
ADDRESS:	59921 JOLON ROAD		TELEPHONE:	(831) 202-1223
CITY:	SAN ARDO	STATE: CA	ZIP CODE:	93450
CAPACITY: 24	TOTAL ENROLLED CHILDREN: 24	CENSUS: 8	DATE:	09/09/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:45 AM
MET WITH:	Guadalupe Lazo		TIME COMPLETED:	12:25 PM

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	On 09/09/2021 at 10:45 AM, Licensing Program Analyst (LPA), Susy Cervantes, conducted an annual visit to the Facility. LPA met with Guadalupe Lazo, director, and explained the nature of today’s visit. LPA toured the Facility both inside and outside during today’s 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), Menus, and Activity Schedule. A listing of staff criminal record clearances associated to this facility in the CCL Licensing Information System (LIS) on 09/07/2021 was reviewed; and it indicates that all Facility staff or other individuals who require caregiver background clearances have received criminal record and child abuse index clearances or exemptions. LPA also reminded them of the applicable civil penalties for those adults who have not received fingerprint clearance, 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 violations within a 12 month period. LPA observed the medical assessment and the Information and Emergency Information form (LIC 700) in 3 children’s files. LPA observed the required health screening in 2 staff files. Director has current CPR and First Aid Certifications on file expiring: 07/2023. 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 (field trips). Director understands the conditions, limitations, and capacity specifications of the Facility license. Director understands that children shall be visually supervised at all times. LPA reviewed the sign-in, sign-out sheets for the past 30 days and received a Child Care Facility Roster and all were in compliance. LPA observed the teacher/child ratio was in compliance during today’s visit: 2 teacher with 8 children. *Continues on report dated 09/09/2021 pg. 1/2*

SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Susy Cervantes
LICENSING EVALUATOR SIGNATURE:	DATE: 09/09/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2021

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: SAN ARDO EARLY EDUCATION & CHILD CARE CENTER	FACILITY NUMBER: 274416218
	VISIT DATE: 09/09/2021

NARRATIVE

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Continuation of report dated 09/09/2021 pg. 2/2

LPA observed that all rooms are clean and safe for all children and staff. Drinking water is readily available for the children in each room and in the outdoor playground area via water dispensers. LPA observed solid waste containers with tight-fitting lids in each room and in the playground area. Staff and children’s bathrooms are clean, sanitary, and operable. There is a separate staff bathroom not utilized by the children which an isolated child can use if needed. Director states that there are no weapons on the premises. LPA observed 2 3A40BC fire extinguishers that were serviced on 08/16/2021, a working dual smoke and carbon monoxide detector and a drill log that was last conducted on 08/27/2021.

The food preparation area is adequately equipped with ovens, refrigerators, and hot and cold running water. There is also adequate food for snacks and regular meals for the children. Cleaning supplies are inaccessible to the children and stored in a locked cabinet in the staff lounge area. Any medications at the Facility are stored appropriately and in the off limits kitchen. LPA reviewed the Facility’s medicine log and medication lock box during today’s visit.

LPA observed all furniture and equipment is in good condition and safe for the children. 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 also sufficient resilient materials (type: turf) in the outdoor playground area. LPA did not observe any bodies of water.

LPA discussed Zero Tolerance with $500 civil penalty and the requirements of AB633 with the director, Guadalupe Lazo, and provided them the AB633 fact sheet and a copy of Acknowledgement of Receipt of Licensing Reports (LIC 9224) and they understand the requirements. Licensing Forms, Title 22 Regulations and Information can be obtained through the internet at www.cdss.ca.gov.

LPA conducted an exit interview with Director. No deficiencies were cited during today's visit.

NOTICE OF SITE VISIT WAS ISSUED AND MUST BE POSTED FOR 30 DAYS.

SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Susy Cervantes
LICENSING EVALUATOR SIGNATURE:	DATE: 09/09/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2021

LIC809 (FAS) - (06/04)

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