444403570-5-31-2023-07-CC-CNEN-CSCR5E-20230531124300

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 444403570
Report Date: 05/31/2023
Date Signed: 05/31/2023 12:43:05 PM

Document Has Been Signed on 05/31/2023 12:43 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:	HOLY CROSS PRESCHOOL		FACILITY NUMBER:	444403570
ADMINISTRATOR:	PATANO, PATRICIA		FACILITY TYPE:	850
ADDRESS:	170 A HIGH STREET		TELEPHONE:	(831) 425-1782
CITY:	SANTA CRUZ	STATE: CA	ZIP CODE:	95060
CAPACITY: 31	TOTAL ENROLLED CHILDREN: 21	CENSUS: 20	DATE:	05/31/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:18 AM
MET WITH:	Crissy Roubal		TIME COMPLETED:	12:55 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	Licensing Program Analyst (LPA), Cortney Nelson, met with Site Supervisor, Crissy Roubal, for an unannounced Required- 1 Year Inspection. LPA was granted access to the facility by the Site Supervisor and toured both indoors and outdoors during the inspection. The facility is located inside Holy Cross Church, entrance to the preschool is located at the back of the church. Upon arrival, there were twenty one preschool-age children and three staff members which is compliant with the facility license capacity and ratio requirements. One staff member was identified as Guy, the gym teacher from Holy Cross School. Crissy states that Guy will occasionally assist the preschool as he is aide qualified and fingerprint cleared. LPA observed all required postings near the entrance to the facility and the hours of operation are Monday – Friday, 7:30AM-4:30PM. LPA reviewed sign-in/out sheets, facility roster (LIC9040), and fire/disaster drill log and observed last drill was conducted 4/27/2023. Sign-in/out was observed to be completed with full legal signature and time of day. LPA observed a fully charged 3A40BC fire extinguisher and functioning carbon monoxide detector. The facility has a built in fire detection system. Crissy states that she does not currently have any children in care who require Incidental Medical Services and does not administer medication at this time. There are no weapons or firearms on the premises. Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual- Regulation Interpretations and Procedures for Child Care Centers, Section 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 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

SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Cortney Nelson
LICENSING EVALUATOR SIGNATURE:	DATE: 05/31/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/31/2023

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: HOLY CROSS PRESCHOOL	FACILITY NUMBER: 444403570
	VISIT DATE: 05/31/2023

NARRATIVE

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Indoor areas of the facility were inspected by the LPA and observed to be clean, orderly, and safe for the day care children. During today's inspection, LPA observed children engaged in activities such as singing songs, playing with play-doh, and eating snack. There are sufficient age-appropriate materials, toys, and play equipment in the facility. Drinking water is readily available for children via water dispensers and disposable cups. 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 necessary. There is a working telephone. The facility completed water lead testing by CRWA on 7/21/2022 and all action level exceedances have been remediated.

LPA discussed with Crissy regarding bathroom use at the facility and integration of school gym bathrooms due to capacity of 31 children. LPA requested that the facility determine a plan of operation to maintain bathroom ratios (1 sink & toilet per 15 children) as well as provide a space to isolate a child due to illness. The facility currently has a waiver for isolating a sick child.

The outdoor area of the facility was inspected and observed to be fenced in. LPA observed play equipment was in good condition, age-appropriate, and has sufficient resilient materials (tanbark) to absorb falls. Crissy states that gardners assist with maintaining the outdoor area on the weekends. No outdoor bodies of water were observed during today’s inspection. Shaded rest area is provided by canopy and Crissy states that tents will be utilized in the summer to provide additional shade. There is a playground, planter box, bikes, and other equipment for children to play with outside.

Five children’s files and two staff files were reviewed today and all required documents were present. The Site Supervisor has current CPR/First-Aid that expires 8/2023 and Mandated Reporter Training that expires on 5/18/2024. LPA reminded both trainings must be renewed every 2 years.

Exit interview conducted and report was reviewed with the Site Supervisor, Crissy Roubal.

As a result of today’s inspection, no deficiencies were cited.

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

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.

SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Cortney Nelson
LICENSING EVALUATOR SIGNATURE:	DATE: 05/31/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/31/2023

LIC809 (FAS) - (06/04)

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