444417119-10-5-2023-07-CC-CNEN-CWBTJD-20231005144611

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 444417119
Report Date: 10/05/2023
Date Signed: 10/05/2023 02:46:16 PM

Document Has Been Signed on 10/05/2023 02:46 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:	SPROUTS SC SPRING HILL		FACILITY NUMBER:	444417119
ADMINISTRATOR:	ETHAN DOWNEY		FACILITY TYPE:	840
ADDRESS:	250 CALIFORNIA STREET		TELEPHONE:	(831) 227-9664
CITY:	SANTA CRUZ	STATE: CA	ZIP CODE:	95060
CAPACITY: 32	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	10/05/2023
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	11:15 AM
MET WITH:	Jordan Bemel		TIME COMPLETED:	03:05 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 Applicant, Jordan Bemel, for an announced pre-licensing inspection. The Applicant, Sprouts SC LLC, is applying for a school-age license with a capacity of 32, serving ages 4.9 to 12 years old. The facility is located at Spring Hill School located in the multipurpose room and a fire clearance was approved on 6/21/2023 by City of Santa Cruz Fire Department. The facility will be open Monday-Friday 2:00pm-5:30pm. Sprouts SC Spring Hill will be operating on a functioning school site and is exempt from square-footage for indoor and outdoor activity space, sink/toilet, fencing, and isolation space requirements for child day care centers, pursuant to Health and Safety Code Section 1596.806. LPA toured the inside and outside of the facility. Jordan states that he plans for children to meet at the school-age playground when school is dismissed and kindergarteners will be picked up from their classrooms. The facility has indoor space in the multipurpose room and LPA observed that there are 50 chairs, 50 hooks, and 12 tables available for use. The multipurpose room is equipped with a locked cabinet for Sprouts equipment and has art materials, legos, blocks, board games, and books. Disinfectant, cleaning supplies, and other items that are dangerous to children will be stored in the storage cabinet. There is a fully charged 3A40BC fire extinguisher, functioning smoke detector and carbon monoxide detector. Facility representative state that there are no weapons or firearms stored on the premise. The facility will be using the boys and girls restroom on campus, which provides individual privacy and is separated for each gender. There are three toilets/ two sinks in the girls bathroom and three urinals/ two toilets/ two sinks in the boys bathroom. The children will be walked to the restroom as needed and there is a staff bathroom on the school campus.

SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Cortney Nelson
LICENSING EVALUATOR SIGNATURE:	DATE: 10/05/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/05/2023

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: SPROUTS SC SPRING HILL	FACILITY NUMBER: 444417119
	VISIT DATE: 10/05/2023

NARRATIVE

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The facility will be using school-age playground and grass field on campus. There are tables with umbrellas for shade, basketball courts, soccer nets, and various outdoor equipment for the children to utilize. Areas around the play structure and swings have resilient materials to absorb falls. LPA advised maintaining tanbark under the swings and slides when children are in care. There were no bodies of water observed during today's inspection. There is a drinking fountain located outside that children can use and they will also bring their water bottles outside.

The facility will be providing snacks for the children and there is menu posted. The school has a kitchen that can be used by the facility for preparing snacks that may need refrigeration or cooking. The kitchen is centrally located and rolling carts are available for transporting snacks to the multipurpose room. Drinking water is provided through filtered water fountains and water bottles.

The facility does not plan on transporting children.

LPA reviewed with facility representative the LIC 311A, Records To Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted.

The Applicant was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5-days or, if the penalty is for a repeat violation, for a maximum of 30-days per person will be assessed if this regulation is violated.

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, available at: http://www.ada.gov/childqanda.htm

SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Cortney Nelson
LICENSING EVALUATOR SIGNATURE:	DATE: 10/05/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/05/2023

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: SPROUTS SC SPRING HILL	FACILITY NUMBER: 444417119
	VISIT DATE: 10/05/2023

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The Applicant was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.

To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

Exit interview conducted and report was reviewed with the facility representative, Jordan Bemel.

LPA advised a license for a school-age center will be granted following review and approval by a Licensing Program Manager and the following corrections:
-Submit letter indicating capacity for multipurpose room from the school principal/superintendent

SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Cortney Nelson
LICENSING EVALUATOR SIGNATURE:	DATE: 10/05/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/05/2023

LIC809 (FAS) - (06/04)

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