274417035-3-21-2023-07-CC-SCES-CQ5T3Z-20230321142307

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 274417035
Report Date: 03/21/2023
Date Signed: 03/21/2023 02:23:17 PM

Document Has Been Signed on 03/21/2023 02:23 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:	MAOF GREENFIELD ELC		FACILITY NUMBER:	274417035
ADMINISTRATOR:	ROZHGAR AZIZ;JANET KINDRED		FACILITY TYPE:	830
ADDRESS:	131 13TH STREET		TELEPHONE:	(831) 214-5731
CITY:	GREENFIELD	STATE: CA	ZIP CODE:	93927
CAPACITY: 18	TOTAL ENROLLED CHILDREN: 18	CENSUS: 0	DATE:	03/21/2023
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	11:05 AM
MET WITH:	Janet Kindred and Rozhgar Aziz		TIME COMPLETED:	02:35 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	On 03/21/2023 at 11:05 AM, Licensing Program Analyst (LPA), Susy Cervantes, met with director, Janet Kindred for a pre-licensing visit. LPA toured the facility both inside and out as well as measured the indoor and outdoor space. A fire clearance for 18 infants has not been received prior to today's visit. Supervisor, Rozhgar Aziz, arrived later on during the inspection. The following indoor measurements were taken today: Infant Room Main Area 35.333 x 19.167 = 677.23 minus 28.05 (encumbered space) = 649.18 Infant Room Side Area 11.833 x 6.5 = 76.91 minus 27.94 (encumbered space) = 48.97 *TOTAL INFANT INDOOR SPACE: 649.18 + 48.97 = 698.15 sq. ft. divided by 35 = 19 children.* LPA informed director and supervisor that the indoor space has space for 19 children, facility has requested 18. There are sinks 2 (30) and 1 toilet (15) available for the children that are potty training as well as 2 changing tables. Only cold water is available in the children's sinks. There is a separate staff bathrooms that will be used by the sick child. The sick child will be isolated in the office and isolation equipment is provided. LPA observed no fireplaces or wall heaters at the facility. The rooms have appropriate lighting. The center will be administering medication and the medication lock box is located in the office. First aid supplies are stored in each room and the office, are adequate and are inaccessible to children. Carbon monoxide detectors are operable. There is one 2A10BC fire extinguisher that was serviced on 12/13/2022 in the infant classroom. Cleaning supplies are stored inaccessible to the children. The center will be providing snacks and meals for the children and will be prepared in the on site kitchen. *Continues on report dated 03/21/2023_______________________________________ pg 1/3*

SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Susy Cervantes
LICENSING EVALUATOR SIGNATURE:	DATE: 03/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2023

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: MAOF GREENFIELD ELC	FACILITY NUMBER: 274417035
	VISIT DATE: 03/21/2023

NARRATIVE

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Continuation of report dated 03/21/2023_______________________________________ pg 2/3

The kitchen is equipped with refrigerator, microwave, stove, dishwasher, and sink with hot and cold running water. Plastic dishes and cups will be utilized for the children and will be hand washed. LPA observed solid waste container with tight-fitting lid in the kitchen. There are 18 cubbies, 3 tables, 14 chairs, 6 cribs and 12 cots. Drinking water is available indoors and out by water dispenser.

Outdoor measurements:

INFANT PLAYGROUND 62 x 39.25 = 2433.50
INFANT PLAYGROUND SIDE AREA 18 x 11 = 198
TOTAL PRESCHOOL OUTDOOR SPACE: 2433.50 + 198 = 2631.50 sq. ft. divided by 75 = 35 children.

The playground is surrounded by appropriate fencing. There is sand and pour and play as resilient material. LPA observed no bodies of water. Shade is provided by canopies. There is a working telephone number for the center which is (831) 674-5810. No transportation is provided by the school.

Director and supervisor were 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, 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.

LPA discussed the safe sleep regulations with director and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed director of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Susy Cervantes
LICENSING EVALUATOR SIGNATURE:	DATE: 03/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2023

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: MAOF GREENFIELD ELC	FACILITY NUMBER: 274417035
	VISIT DATE: 03/21/2023

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Continuation of report dated 03/21/2023_______________________________________ pg 3/3

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

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 director and supervisor Janet Kindred and Rozhgar Aziz. Director was advised that licensure for 18 infants is approved pending the following:

- Sleep area partitions need to be at least 4 feet high
- Fire Inspection clearance with request for 18 infants
- Management's approval

SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Susy Cervantes
LICENSING EVALUATOR SIGNATURE:	DATE: 03/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2023

LIC809 (FAS) - (06/04)

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