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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 440702020
Report Date: 10/14/2022
Date Signed: 10/14/2022 01:37:23 PM

Document Has Been Signed on 10/14/2022 01:37 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:CKC SANTA CRUZ GARDENSFACILITY NUMBER:
440702020
ADMINISTRATOR:SAREE WALKERFACILITY TYPE:
840
ADDRESS:8005 WINKLE AVENUETELEPHONE:
(831) 475-5925
CITY:SANTA CRUZSTATE: CAZIP CODE:
95065
CAPACITY: 65TOTAL ENROLLED CHILDREN: 53CENSUS: 22DATE:
10/14/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Heidi ListerTIME COMPLETED:
01:48 PM
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Licensing Program Analyst (LPA), Cortney Nelson, met with Hiring Director, Heidi Lister, for an unannounced Required- 1 Year Inspection. LPA was granted access to the facility by Teachers Assistant, Mercedes, and toured both indoors and outdoors during the inspection. Heidi states that Executive Director, Noel Shermann, and Site Director, Elisa Bridges, are both off today and that she will receive the report instead. The facility is located on the campus of Santa Cruz Gardens Elementary School in a portable. Upon arrival, there were no children present, however by 1:00PM LPA observed 22 children and four (4) staff members present, which is compliant with the facility capacity and ratio requirements. LPA observed all required postings near the entrance to the facility. Hours of operation for the facility are Monday – Thursday, 1:00PM-6:00PM and Friday (early release day) 11:45AM-6:00PM.

LPA reviewed sign-in/out iPad, facility roster, and fire/disaster drill log during today’s inspection. Sign-in/out was observed to be completed electronically utilizing the Application, Brightwheel, with full legal signature and time of day. Children in grades 1st-5th walk themselves to the after-school program and children in TK and kindergarten are escorted by facility staff from their classrooms. The last fire/disaster drill was conducted on 9/19/2022, which is compliant with the six-month requirement for facilities. LPA observed a fully charged 3A40BC fire extinguisher (last serviced: 8/2022) and functioning carbon monoxide detector. The facility has a built in fire alarm system as it is on a school campus. LPA advised that carbon monoxide detector should be plugged in at all times. Facility Representative states that there is a child in care who require Incidental Medical Services and one child with medication at this time. LPA observed medication is properly stored out of reach of children with the proper documentation. LPA advised that medication can be stored inaccessible without locked box and advised doing so for EpiPens as staff will want to access medication quickly in an emergency. The Facility Representative states that there are no weapons or firearms on the premises.
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Cortney Nelson
LICENSING EVALUATOR SIGNATURE: DATE: 10/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/14/2022
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: CKC SANTA CRUZ GARDENS
FACILITY NUMBER: 440702020
VISIT DATE: 10/14/2022
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This facility provides Incidental Medical Services- IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual- Regulation Interpretations and Procedures for Child Care Centers, Section 101173 and 101226. The following information regarding ADA was provided: US Department of Justice 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

Indoor areas of the facility were inspected by the LPA today and observed to be clean, orderly, and safe for the day care children. LPA observed sufficient age-appropriate materials, toys, and play equipment in the facility. The floors were clean and free of tripping hazards. Drinking water is readily available for children in the facility via water dispensers and disposable cups. The facility utilizes a children's bathroom located on the school campus and staff walk children to the bathroom as needed. Staff bathroom is additionally located on campus separate from the CKC portable. Staff and children’s bathrooms are clean, sanitary, and operable. There is a working telephone in the facility. Heidi states that the multi purpose room is used during rainy days and that the portable is the primary space for after-school care.

The outdoor area of the facility was inspected and LPA observed that the facility uses playground located on the school campus for children. Play equipment and playground structure is in good condition, age-appropriate, and has sufficient resilient materials (rubber padding) to absorb falls. No outdoor bodies of water were observed during today’s inspection. Shaded rest area is provided by canopy and there are two (2) functioning drinking fountains located outside for children's use. Balls and other outdoor equipment are provided for children in care by CKC.

Food is provided by the facility and is stored, prepared, and served in a safe and healthful manner to the children. The facility offers an after-school program and provides afternoon snack to children in care. LPA observed that the menu is in writing and posted at least one week in advance, accessible to authorized representatives. The kitchen and storage area is clean and free of litter and rubbish.

5 school-age children’s files were reviewed and all required documents were present.
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Cortney Nelson
LICENSING EVALUATOR SIGNATURE:

DATE: 10/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/14/2022
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: CKC SANTA CRUZ GARDENS
FACILITY NUMBER: 440702020
VISIT DATE: 10/14/2022
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5 staff files (Site Director/2 Teachers /2 Aides) were reviewed and all required documents were present. There is at least one staff member present with current CPR/First-Aid that expires 1/2023. The Site Director has current Mandated Reporter Training that expires on 3/27/2023. LPA reminded the Facility Representative that the Mandated Reporter Training must be renewed by all staff every 2 years. The facility is subject to waiver for all staff to be fingerprinted and associated to Westlake CKC (#440710576) and LPA observed all staff present today are associated.

The Facility Representative was reminded that all adults 18 and over, 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.

The Facility Representative understands that the Site Director shall be on the premises during the hours the center is in operation and that children at the center shall be visually supervised at all times. LPA reminded Facility Representative 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, such as field trips.

Exit interview conducted and report was reviewed with the Facility Representative, Heidi Lister.

As a result of today’s inspection, no deficiencies were cited.

A NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 DAYS.

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.
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Cortney Nelson
LICENSING EVALUATOR SIGNATURE:

DATE: 10/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/14/2022
LIC809 (FAS) - (06/04)
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