274417120-9-26-2023-07-CC-FCJO-CW2SND-20230926140123

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 274417120
Report Date: 09/26/2023
Date Signed: 09/26/2023 02:01:31 PM

Document Has Been Signed on 09/26/2023 02:01 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:	AGAPE ACADEMY PRESCHOOL		FACILITY NUMBER:	274417120
ADMINISTRATOR:	LISA HAYS		FACILITY TYPE:	850
ADDRESS:	8340 CARMEL VALLEY ROAD		TELEPHONE:	(831) 601-2143
CITY:	CARMEL	STATE: CA	ZIP CODE:	93923
CAPACITY: 41	TOTAL ENROLLED CHILDREN: 41	CENSUS: 20	DATE:	09/26/2023
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Lisa Hays		TIME COMPLETED:	02:15 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 (LPA) Fermin Campos-Jaramillo, conducted an announced pre licensing inspection at the Facility. LPA met with Lisa Hays, Site Director, and explained the nature of today's inspection to them. The Applicant has applied for a license for 41 preschool children at 8340 Carmel Valley Road, Carmel, CA 93923. A fire clearance approval has been received from the Monterey County Regional Fire District prior to this inspection. The Facility will operate Monday through Friday from 8:00 AM to 2:00 PM, serving Preschool children ages 2.9 years to 6 years old. The Preschool center will be utilizing four classrooms, The Faith Hall, and the Grace Chapel of the Sanctuary Bible Church. Updated Facility sketches were provided to LPA prior to today's inspection. LPA toured and measured the indoor and outdoor areas of the Facility with Site Director during today's inspection. INDOOR MEASUREMENTS ARE AS FOLLOWS: Classroom 1: 19.5 x 16.633 = 328.24 square feet Classroom 2: 16.833 x 14.5 = 244.08 square feet Classroom 3: 16.833 x 15.166 = 255.29 square feet Classroom 4: 16.833 x 14.416 = 242.66 square feet Grace Chapel: 29 x 26 = 754 + 17 x 3.916 = 66.57 + 17 x 2 = 34 + 5 x 3.083 = 15.42 Total Grace Chapel 869.99 square feet Preschool Indoor Space Total = 1,940.26 sq. ft. divided 35 sq. ft. = 55 preschool children. ********Report dated 9/26/23 continues on page 2.

SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Fermin Campos-Jaramillo
LICENSING EVALUATOR SIGNATURE:	DATE: 09/26/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2023

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: AGAPE ACADEMY PRESCHOOL	FACILITY NUMBER: 274417120
	VISIT DATE: 09/26/2023

NARRATIVE

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Report dated 9/26/23 continues from page 1

OUTDOOR MEASUREMENTS ARE AS FOLLOWS:

Small Playground (across room 1): 12.666 x 60 = 759.96 square feet
Main playground (across rooms 2,3, and 4): 16 x 161 = 2576 + (159 x 74)/2 = 5883, total main playground 8,459 square feet

TOTAL OUTDOOR SPACE: 9,218.96 sq. ft. divided by 75 = 122 children.

LPA observed that the preschool playground areas have sufficient space for the preschool children and are surrounded by appropriate fencing. LPA observed sufficient outdoor supplies and equipment for the children. LPA observed a play structure in the main playground and that is age appropriate & secure with wood chips surfacing (resilient materials) underneath and surrounding the structures. Shade is provided by a big tree. Drinking water will be provided outdoors via children's own reusable water bottles and a water fountain. LPA did not observe any bodies of water during today's inspection. Transportation will not be provided by the Facility.
This Facility does not plan to provide Incidental Medical Services – IMS at this time. For IMS information, see PIN 22-02-CCP. A 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. LPA advised Site Director that an IMS plan will need to be submitted to the Department if they elect to provide IMS services in the future. Copy of PIN 22-02-CCP provided to the Site Director during today's inspection.
LPA reminded Site Director of the applicable civil penalties for those adults who have not received fingerprint clearances, are not associated to the facility, and who come in contact with or provide care and supervision to the children. For an initial violation, civil penalty amounts to $100.00 per person per day up to $500.00 per person. For a subsequent violation within a 12 month period, civil penalty amounts to $100.00 per person up to $3000.00 per person.
There are 5 sinks (75) and 7 toilets (105) available for the preschool children. There is hot water available in the children's sinks. LPA observed soap dispensers and paper towels in the preschool bathrooms. There is one separate staff bathroom, located near the front of the Facility, that will be utilized by sick children if necessary. Sick children will be isolated in the area close to the office and isolation equipment will be provided. Potty training will not be provided by the Facility.
*******Report dated 9/26/23 continues on page 3.

SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Fermin Campos-Jaramillo
LICENSING EVALUATOR SIGNATURE:	DATE: 09/26/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2023

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: AGAPE ACADEMY PRESCHOOL	FACILITY NUMBER: 274417120
	VISIT DATE: 09/26/2023

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Report dated 9/26/23 continues from page 2.
LPA observed no fireplaces or wall heater units in the Facility. All rooms have appropriate lighting, heating, and air conditioning. First aid kits are stored in each Classroom inaccessible to the children. The Facility has working smoke/carbon monoxide detectors.

There are 8 indoor tables, 41 chairs, 48 cubbies, and 30 cots available for the preschool children. Site Director stated the program serves children for six hours and nap time is not offered. There is adequate equipment, supplies and toys for the children in the Facility. Drinking water will be provided indoors via disposable cups, and pitchers with filtered water. LPA advised required water lead testing within 180 days of receiving license for Child Care Centers. There is a working telephone at the site. Site Director states that there are no firearms or weapons on the premises.
The Facility will not provide meals or snacks to the children. The children will be required to bring to the center their own lunches or snacks daily. LPA observed solid waste containers with tight-fitting lids throughout the Facility. Cleaning supplies are stored in the staff bathroom and are inaccessible to children. There are no poisons in the Facility.

Site Director has obtained the Criminal Record and Child Abuse Index clearances. Site Director has the required education and experience qualification requirements and valid Mandated Reporter Training & Pediatric First Aid/CPR Certifications. Proof of completion of and vaccination records for MMR, Tdap, and Influenza are on file.
LPA reviewed with Site Director the LIC 311A, Records to be Maintained at the Facility (children’s forms/records, facility forms/records, and information to be posted). Copy of form provided to Site Director during today's inspection.

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

LPA conducted an exit Interview and advised the Site Director, Lisa Hays that a license for 41 preschool children will be approved upon completion of the following items:

1) Proof of current Health and Safety Training including the lead poisoning training.
2) Copy of renewal of Mandated Reporter training (AB1207)
2) Final review & approval by Licensing Program Manager.

SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Fermin Campos-Jaramillo
LICENSING EVALUATOR SIGNATURE:	DATE: 09/26/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2023

LIC809 (FAS) - (06/04)

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