434416983-7-26-2021-07-CC-SYIP-C5AUL8-20210726154019

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434416983
Report Date: 07/26/2021
Date Signed: 07/26/2021 03:40:29 PM

Document Has Been Signed on 07/26/2021 03:40 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:	GILROY HEAD START		FACILITY NUMBER:	434416983
ADMINISTRATOR:	RENEE GARCIA / EVA SUAREZ		FACILITY TYPE:	850
ADDRESS:	9300 WREN AVENUE		TELEPHONE:	(669) 212-8692
CITY:	GILROY	STATE: CA	ZIP CODE:	95020
CAPACITY: 43	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	07/26/2021
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	10:01 AM
MET WITH:	Eva Suarez		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 Analyst (LPA) Samantha Yip conducted an announced pre-licensing inspection. LPA met with Site Director Eva Suarez and explained the reason for the inspection. The purpose of this inspection is the facility is requesting a change of location for 43 children ages 2.9 to entry to kindergarten. The facility is currently licensed as Leavsely Head Start #434406697 at 7871 Murrary Avenue, Gilroy 95020. The new location is located in the South County Annex; Room K-1 and Room K-2 and playground adjacent to the rooms. A fire clearance was granted on 07/16/2021 for 43 children. There is board to post required postings. The hours of operation are Monday through Friday 8AM to 4:45PM. There is working phone at the facility, which is (669) 212-8693. LPA toured and measured the inside and outside of the facility. THE INDOOR MEASUREMENTS ARE AS FOLLOW: ROOM K-1: (12.750 x 11.417= 145.566) + (15.250 x 5.083 = 77.515) + (24 x 9.33 = 223.992) + (28 x 15.250 = 427) + (0.583 x 21.250 = 12. 388) + (27.417 x 7.583 = 207.903) + (29.333 x 7.250= 212.664) = 1307.028 minus encumbered space (13.250 x 2.083 = 27.599) + (1.583 x 15.500 = 24.536) = 52.135 = 1307.028- 52.135 = 1254.893 Total Indoor Space: 1254.893 divided by 35 = 35 children --------------------CONTINUES ON 809 DATED 07/26/2021 PAGE 2----------------------------

SUPERVISORS NAME: Anthony Studebaker
LICENSING EVALUATOR NAME: Samantha Yip
LICENSING EVALUATOR SIGNATURE:	DATE: 07/26/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/26/2021

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: GILROY HEAD START	FACILITY NUMBER: 434416983
	VISIT DATE: 07/26/2021

NARRATIVE

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------------------CONTINUATION OF 809 DATED 07/26/2021 PAGE 1-----------------------

ROOM K-2:
(7.667 x 27.333 = 209.562) + (12.750 x 11.667= 148.754) + (35.333 x 14.667 = 518.229) + (30 x 9.083 = 272.49) + (0.58 x 21= 12.243 )+ (7.417 x 3 = 22.251) = 1183.529 minus encumbered space (16.250 x 1.500 = 24.375) + (12.750 x 2.083) = 50.993 = 1183.529-50.993 = 1132.596
Total Indoor Space: 1132.596 divided by 35 = 32 children

THE OUTDOOR AREAS ARE AS FOLLOWED:
77.167x49.750 = 3839.058 + 14.667 x 24 = 352.008 + 57.083 x 54.667= 3120.556 + 3.500 x 44.417 = 155.459 + 13 x 43.250 = 562.25 + 15 x 22.167= 332.505 + 1.167 x 8.667 = 10.114 1.500 x 23.333 = 34.999 + 1/2(38.417 x 38.11)= 732.035 = 9138.984 minus encumbered space 3.667 x 7.7750 = 28.419 + 3(2.250 x 2.250) = 15.187 = 43.606 = 9138.984 - 43.606 = 9095.378
Total Outdoor Space: 9095.378 divided by 75 = 121 children

LPA observed that there are 2 toilets, 2 sinks, 60 cubbies, 43 chairs, 11 tables, and 19 napping mats. Site Director stated that only have one class that will be full-time and napping. Site Director understands that she needs to have a napping mat for each child. Site Director stated that they have access to the girl's restroom, but it would be shared with other programs on site. Site Director stated that she will submit a waiver request to share the bathroom to Licensing by 5PM on 07/30/2021. There are soap dispensers and paper towels for children. All cleaning supplies, disinfectant, and other items that are dangerous to children were observed to stored in a lock cabinet next to the sink. LPA reminded Site Director that anything states to keep out of reach of children, such as odor eliminating spray or hand sanitizers needs to be inaccessible to children. There is a tight fitted trash can for waste. LPA observed that there is sufficient amount of toys for children in care. All furniture and equipment were observed to be age appropriate and in good condition. The isolation area for sick children will be located in Classroom 1/office. There is fully charged fire extinguisher, smoke detector, carbon monoxide detector, and first aid kit. Site Director stated that there are no weapons, such as firearms, stored on the premise.

-------------------CONTINUES ON 809 DATED 07/26/2021 PAGE 3-----------------------------

SUPERVISORS NAME: Anthony Studebaker
LICENSING EVALUATOR NAME: Samantha Yip
LICENSING EVALUATOR SIGNATURE:	DATE: 07/26/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/26/2021

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: GILROY HEAD START	FACILITY NUMBER: 434416983
	VISIT DATE: 07/26/2021

NARRATIVE

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------------CONTINUATION OF 809 DATED 07/26/2021 PAGE 2--------------------------

The outdoor area is surrounded with appropriate fencing. Areas around the play structure and swings have resilient material, rubber mulch, to absorb fall. LPA observed that there are holes in the resilient material. Site Director stated that she will send proof that holes have been filed once completed. LPA also observed that the play structures has two age recommendations; 5-12 and 2-5 on it. Site Director stated that she will follow-up with the manufacture and let LPA know the age recommendations for the play structure. LPA also observed that the steps on the play structure are starting to wear and peel, which could become a hazard for the children. Site Director stated that they are going to be replacing one of the steps with a ladder. She stated that she will send proof to Licensing once that it is complete. There is sandbox in the outdoor area. Site Director stated that they are planning on installing a 4 feet fence around it to make it off-limits until they determine whether they will be keeping the sandbox. Site Director stated that she will follow-up with LPA once that it determined. There were no bodies of water observed during today's inspection. Shaded rest area is provided through building overhang.

The facility does provided meals and snacks to the children. All meals and snacks are prepared and brought from Santa Clara County Office of Education. There is a kitchen to prepare meals and snacks. Sink has hot and cold running water. Drinking water inside is provided through water cooler and cups and through the water fountains and water jug and cups outside.

Facility does plan on providing Incidental Medical Services (IMS). Plan of Providing IMS is on file.

All staff are fingerprinted through Santa Clara County Office of Education. Therefore, all criminal records are monitored through the Santa Clara Country Office of Education.

An exit interview was conducted with Site Director Eva Suarez. Site Director was informed that upon approval of Licensing Management, a license for a preschool child care center will be granted and issued upon completion of the following:
- proof that stairs on the play structure was fixed
- proof that holes resilient materials were filled or fixed
- confirmation of the age recommendation of the play structure
- waiver request to share bathroom
- updated LIC 200A to reflect the change of phone number

SUPERVISORS NAME: Anthony Studebaker
LICENSING EVALUATOR NAME: Samantha Yip
LICENSING EVALUATOR SIGNATURE:	DATE: 07/26/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/26/2021

LIC809 (FAS) - (06/04)

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