444413558-6-7-2024-07-CC-CNEN-D5ZVXA-20240607164914

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 444413558
Report Date: 06/07/2024
Date Signed: 06/07/2024 04:49:25 PM

Document Has Been Signed on 06/07/2024 04:49 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:	GIVING TREE ACADEMY		FACILITY NUMBER:	444413558
ADMINISTRATOR:	SOSA, JENNIFER		FACILITY TYPE:	850
ADDRESS:	175 LAWRENCE AVENUE		TELEPHONE:	(831) 254-0983
CITY:	WATSONVILLE	STATE: CA	ZIP CODE:	95076
CAPACITY:	90	CENSUS: 22	DATE:	06/07/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:21 AM
MET WITH:	Jenifer Sosa		TIME COMPLETED:	04:58 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 Analysts (LPAs), Cortney Nelson and Jennifer 'Jen' Beehler, met with Site Director, Jenifer Sosa, for an unannounced Annual/Random Inspection. LPAs were granted access to the facility by the Site Director and toured both indoors and outdoors during the inspection. Upon arrival, there were twenty-two (22) preschool-age children and four (4) staff members present, which is compliant with the facility license capacity and ratio requirements. LPA observed all required postings near the entrance to the facility and the hours of operation are Monday – Friday, 7:00AM-5:00PM. LPAs reviewed sign-in/out sheets, facility roster (LIC9040), and fire/disaster drill log during today’s inspection. Sign-in/out was observed to be completed with full legal signature and time of day. The last fire drill was conducted on 1/26/2024, which is compliant with the six-month requirement for facilities. LPAs observed two fully charged 3A40BC fire extinguishers (last serviced: 7/2023), functioning carbon monoxide detector, and a built in fire detection system. LPAs advised annual servicing of fire extinguishers in the facility. Jenifer 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. LPAs additionally reminded the Site Director that the annual fee for the facility is due on 6/28/2024. Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

SUPERVISOR'S NAME: Joel Segura	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Cortney Nelson	TELEPHONE: (916) 956-5037
LICENSING EVALUATOR SIGNATURE:	DATE: 06/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2024

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: GIVING TREE ACADEMY	FACILITY NUMBER: 444413558
	VISIT DATE: 06/07/2024

NARRATIVE

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Indoor areas of the facility were inspected by the LPAs today and observed to be clean, orderly, and safe for the day care children. The Site Director states that Modular Building C (Classrooms: A-F) is not in use and will be removed from the licensed areas of the preschool component. LPAs advised that an Application for a Child Care Center (LIC200A), $25 capacity reduction fee, shall be submitted to the Department within 30 days (7/8/2024). Once received, the application will be processed by the centralized application bureau (CAB) and an updated fire clearance will be obtained. LPAs further advised that the capacity of the facility will be reduced and to estimate the new capacity on the LIC200A that will be submitted.

Furniture, such as tables, chairs, and shelves, are in good condition and safe for children. The floors were clean and free of tripping hazards. Drinking water is readily available for children via water bottles from home and if they need refilling, plastic disposable water bottles are available. The 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 in the facility.

The outdoor area of the facility was inspected and observed to be fenced in. LPAs observed play equipment was in good condition and age-appropriate. The Site Director states that one of the playgrounds is planned to be removed once final church approval has been processed. LPAs advised barricading off access to the playground as it is not developmentally appropriate for preschool-age children. LPAs additionally advised that the playground needs more resilient materials (tanbark) as the surface beneath the tanbark is visible. No outdoor bodies of water were observed during today’s inspection. Shaded rest area is provided by large trees and building overhang. LPAs advised adding additional shaded rest area on sunny days, such as a pop up canopy.

The facility provides AM/PM snack to the children and lunch is provided by the children. The Site Director states that parents place an ice pack in the lunch boxes for items that may need refrigeration and parents are advised that lunch boxes remain in the child's cubby until lunch is served. The snack menu is in writing and posted in the kitchen and follows a rotating schedule. LPAs advised that the menu should be posted at least one week in advance, accessible to authorized representatives and recommended posting in the parent area, near the classroom entrance. The kitchen and storage area is clean and free of litter and rubbish.

SUPERVISOR'S NAME: Joel Segura	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Cortney Nelson	TELEPHONE: (916) 956-5037
LICENSING EVALUATOR SIGNATURE:	DATE: 06/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2024

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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: GIVING TREE ACADEMY	FACILITY NUMBER: 444413558
	VISIT DATE: 06/07/2024

NARRATIVE

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Five (5) childrens files were reviewed and all required documents were present. LPAs advised obtaining updated immunization records for children in care and maintaining in the file until children are up to date for TK/K readiness.

Four (4) staff files were reviewed and most required documents were present. LPAs reminded that staff must maintain proof of immunization to measles, pertussis, and flu/declination for flu and shall renew their mandated reporter training every two years. The Site Director has current first-aid/CPR that expires 7/2025.

Licensee 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.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for
drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. The facility has not completed water lead testing and has advised that children in care are offered disposable water bottles when drinking water is given. LPAs advised that any faucets used for food preparation shall also be tested for water lead contamination. If the facility does not use any faucets for drinking water or food preparation, a written attestation shall be submitted to the Department along with a facility sketch indicating all water faucets in the facility.

Exit interview conducted and report was reviewed with the Site Director, Jenifer Sosa.

As a result of today’s inspection, deficiencies were cited, see LIC809-D.

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 may 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 CARE tools, please send email inquiries 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/inspection-process.

SUPERVISOR'S NAME: Joel Segura	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Cortney Nelson	TELEPHONE: (916) 956-5037
LICENSING EVALUATOR SIGNATURE:	DATE: 06/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2024

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 06/07/2024 04:49 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: GIVING TREE ACADEMY	FACILITY NUMBER: 444413558
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/07/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

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 record review and interview, the licensee did not comply with the section cited above as the facility has not completed water lead testing, which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 06/28/2024
	Plan of Correction
1 2 3 4	The facility shall submit date for water lead testing if any faucets are used for food preparation or drinking water. If none are used for those purposes, the facility shall submit written attestation and facility sketch that indicates all faucets in the facility. Test date or attestation shall be submitted by 6/28/2024.

Type B

Section Cited

CCR

101238.2(d)(2)

Outdoor Activity Space

(d) The surface of the outdoor activity space shall be maintained: (2) Free of hazards including, but not limited to, holes, broken glass and other debris, and dry grasses that pose a fire hazard. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation and interview, the licensee did not comply with the section cited above as the grass area currently has holes from animals, which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 06/28/2024
	Plan of Correction
1 2 3 4	The facility shall maintain the grass area and remove/fill in holes from animals from areas that are accessible to children. Photos shall be submitted to the Department by 6/28/2024.

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: Cortney Nelson	TELEPHONE: (916) 956-5037
LICENSING EVALUATOR SIGNATURE:	DATE: 06/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2024

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 06/07/2024 04:49 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: GIVING TREE ACADEMY	FACILITY NUMBER: 444413558
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/07/2024

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 and interview, the licensee did not comply with the section cited above as there is not sufficient tanbark in the playground area, the dirt surface underneath is visible throughout the area, which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 06/28/2024
	Plan of Correction
1 2 3 4	The facility shall add more tanbark to the playground area and ensure that the surface beneath is not visible, especially in areas where the monkey bars and slide are located. Photos to be submitted by 6/28/2024.

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review and interview, the licensee did not comply with the section cited above as four staff members are missing proof of current Mandated Reporter training, which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 06/21/2024
	Plan of Correction
1 2 3 4	The facility shall submit proof of completion for Mandated Reporter training for four staff members to the Department by 6/21/2024. (www.mandatedreporterca.com) Child Care Providers- AB1207

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: Cortney Nelson	TELEPHONE: (916) 956-5037
LICENSING EVALUATOR SIGNATURE:	DATE: 06/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2024

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 06/07/2024 04:49 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: GIVING TREE ACADEMY	FACILITY NUMBER: 444413558
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/07/2024

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
1 2 3 4	Based on record review and interview, the licensee did not comply with the section cited above as two staff members are missing proof of immunity to measles, which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 06/28/2024
	Plan of Correction
1 2 3 4	The facility shall submit proof of immunity to measles for two staff members to the Department by 6/28/2024.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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: Cortney Nelson	TELEPHONE: (916) 956-5037
LICENSING EVALUATOR SIGNATURE:	DATE: 06/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2024

LIC809 (FAS) - (06/04)

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