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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 270710408
Report Date: 10/18/2024
Date Signed: 10/18/2024 11:28:09 AM

Document Has Been Signed on 10/18/2024 11:28 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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:ELKHORN PRE KINDERSFACILITY NUMBER:
270710408
ADMINISTRATOR/
DIRECTOR:		SANDRA CUEVASFACILITY TYPE:
850
ADDRESS:2235 ELKHORN ROADTELEPHONE:
(831) 633-5975
CITY:CASTROVILLESTATE: CAZIP CODE:
95012
CAPACITY: 40TOTAL ENROLLED CHILDREN: 40CENSUS: 10DATE:
10/18/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:25 AM
MET WITH:Jeanette JimenezTIME VISIT/
INSPECTION COMPLETED:
11:35 AM
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Licensing Program Analyst (LPA) Andrea Cortez conducted an unannounced Required - 1 Year Inspection. The purpose of today’s visit is to ensure the facility is in compliance with Title 22 California Code of Regulations. LPA met with the Lead Teacher (LT) Jeanette Jimenez and explained the nature of today's inspection. The preschool is located on the Elkhorn Elementary School campus in classrooms B11 and A9 (B11 is currently under construction and not being utilized). LPA toured the Facility both inside and outside during inspection. The facility has an active waiver allowing the preschool children to share bathroom facilities.
LPA observed census at 10 with 2 teachers and 2 paraprofessionals. 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), and Activity Schedule. LPA observed water dispenser and children’s water bottles are filled as needed. The school has two sessions a morning and afternoon. The morning class hours of operation are Monday - Friday, 7am – 11am and serves breakfast with snack. The afternoon session 11:30am-2:30pm and serve lunch with snack.

LPA reviewed ten children's and three staff files during today's visit. Each child's file reviewed contains the Information and Emergency Information form (LIC 700), immunization records, physicians report, personal rights, and parents rights. All staff have clearance through North Monterey County Unified School District. All staff files contain the required transcripts/verification of experience. All staff's CPR and First Aid certifications are current. The LT 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).

Clearances for individuals at this facility who require caregiver background checks are issued by State Department and/or County Office of Education and do not come under the jurisdiction of Community Care Licensing Division.

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Andrea Cortez
LICENSING EVALUATOR SIGNATURE: DATE: 10/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/18/2024
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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: ELKHORN PRE KINDERS
FACILITY NUMBER: 270710408
VISIT DATE: 10/18/2024
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LT understands the conditions, limitations, and capacity specifications of the Facility license. LT understands that children shall be visually supervised at all times. LPA observed classrooms in order. LPA observed solid waste containers with tight-fitting lids in classroom. Staff and children's bathrooms are clean, sanitary. 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 or firearms on the premises.

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. The preschool playground is separate from the school outdoor space. LPA observed that the outdoor equipment is age appropriate. LPA did not observe any bodies of water. All meals are prepared by the Elkhorn Elementary School cafeteria. The food preparation and storage areas are clean, free of litter & rubbish, and free of rodents and other vermin. Cleaning supplies are securely stored and inaccessible to the children. LPA observed a fully charged 2A10BC fire extinguisher and working smoke/carbon monoxide detectors. LT states that the Facility does not administer medications at this time.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 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 (USDOJ) 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

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/inspection-process.

No deficiencies cited, exit interview conducted and report was reviewed with the Lead Teacher Jeanette Jimenez.A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Andrea Cortez
LICENSING EVALUATOR SIGNATURE:

DATE: 10/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/18/2024
LIC809 (FAS) - (06/04)
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