440710237-8-17-2023-07-CC-CNEN-CUSNPK-20230817103829

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 440710237
Report Date: 08/17/2023
Date Signed: 08/17/2023 10:38:33 AM

Document Has Been Signed on 08/17/2023 10:38 AM - 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:	DE LA VEAGA CKC INC.		FACILITY NUMBER:	440710237
ADMINISTRATOR:	MILLETE, JAHMAR		FACILITY TYPE:	840
ADDRESS:	1145 MORRISSEY BOULEVARD		TELEPHONE:	(831) 426-7402
CITY:	SANTA CRUZ	STATE: CA	ZIP CODE:	95065
CAPACITY:	200	CENSUS: 0	DATE:	08/17/2023
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	09:48 AM
MET WITH:	Kylie Roberts, Elisa Bridges, Blaise Skelton, & Jahmar Millete		TIME COMPLETED:	10:49 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), Cortney Nelson, met with Executive Director, Kylie Roberts, Operations Specialist, Elisa Bridges, After-School Coordinator, Blaise Skelton, and Site Director, Jahmar Millete, in response to adding a classroom for use by the facility. Upon arrival, LPA met with Kylie and Elisa in front of the De LaVeaga Elementary School office and toured classroom #42. LPA met with Blaise and Jahmar upon arrival to classroom #42. The facility is currently licensed for rooms #34, #35, and #33 (multipurpose room). The facility is adding a newly constructed portable, room #42, for use by Campus Kids Connection (CKC). LPA was provided letter from Jim Monreal, Assistant Superintendent of Business Services, approving use by CKC for room #42. Jahmar states that room #34 will be used for children in 1st and 2nd grade, room #35 for children in Transitional Kindergarten and Kindergarten, room #42 for children in grades 3rd, 4th, and 5th, and room #33 (multipurpose room) will be used for overflow or rainy days. LPA toured room #42 and observed that it is equipped with three tables, thirty chairs, and various activity zones, such as art, blocks, games, reading, and kitchen. Jahmar states that the room will only be used by CKC. There is a fully charged 3A40BC fire extinguisher (last serviced: 7/2023) and functioning carbon monoxide detector. The room has a built in fire/smoke detector system. All required postings were observed near the entrance of the room and LPA advised adding license once room is approved for use. There is a refrigerator for storing food items for snack and is also equipped with a brita water filter for drinking water. The room additionally has an air purifier equipped. LPA reviewed personnel report (LIC500) for the facility and observed there are seven teachers and one assistant employed. Jahmar states that there are currently 120 children enrolled, however they do not all attend on the same days. He additionally states that he will be in ratio as needed to maintain staff child ratio requirements.

SUPERVISOR'S NAME: Joel Segura	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Cortney Nelson	TELEPHONE: (916) 956-5037
LICENSING EVALUATOR SIGNATURE:	DATE: 08/17/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2023

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: DE LA VEAGA CKC INC.	FACILITY NUMBER: 440710237
	VISIT DATE: 08/17/2023

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The facility does not currently have any hooks installed for children's personal belongings and states that they are planning to install 40-50 hooks for the children along the rail outside the classroom door. LPA advised using temporary alternative storage for children's belongings until hooks can be installed. There are cubbies located in the room, however they are too small to hold children's backpacks. LPA requested photos are submitted once hooks are installed onto portable #42 and to submit plan for temporary solution.

LPA received updated facility sketch, campus map with CKC classrooms indicated, updated Emergency Disaster Plan (LIC610), letter of approval from superintendent, and updated Application for a Child Care Center (LIC200A).

As a result of todays inspection, no deficiencies were cited.

Exit interview conducted and report was reviewed with Executive Director, Kylie Roberts, Operations Specialist, Elisa Bridges, and Site Director, Jahmar Millete.

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

LPA advised that license for portable #42 will be issued pending manager review and approval.

SUPERVISOR'S NAME: Joel Segura	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Cortney Nelson	TELEPHONE: (916) 956-5037
LICENSING EVALUATOR SIGNATURE:	DATE: 08/17/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2023

LIC809 (FAS) - (06/04)

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