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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 440703706
Report Date: 04/09/2024
Date Signed: 04/10/2024 11:16:48 AM

Document Has Been Signed on 04/10/2024 11:16 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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:FREEDOM CHILDREN'S CENTERFACILITY NUMBER:
440703706
ADMINISTRATOR/
DIRECTOR:		MARIA FERNANDEZFACILITY TYPE:
850
ADDRESS:37 HOLLY DRIVETELEPHONE:
(831) 786-2300
CITY:FREEDOMSTATE: CAZIP CODE:
95019
CAPACITY: 64TOTAL ENROLLED CHILDREN: 64CENSUS: 24DATE:
04/09/2024
TYPE OF VISIT:Case Management - Annual ContinuationUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:50 AM
MET WITH:Maria "Lupe" Fernandez TIME VISIT/
INSPECTION COMPLETED:
03:45 PM
NARRATIVE
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Licensing Program Analyst (LPA) Elizabeth Larios conducted an unannounced Case Management Required - 3 Year Continuation 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 Director Maria "Lupe" Fernandez, and explained the nature of today's visit. LPA toured the facility both inside and outside in prior visit. 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 in each classroom 1 & 2. The hours of operation are Monday - Friday, 8:00am - 5:00pm.

LPA reviewed children's 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. LPA reviewed staff files during today's visit. All staff have fingerprint clearances. Staff has current CPR and First Aid certifications on file. Staff have Health Screening Report and TB test, Immunization (Measles, Pertussis, and Flu) record and required Training. Staff had current Mandated Reporter Training certificate. Site Supervisor 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.

Site Supervisor understands the conditions, limitations, and capacity specifications of the facility license. Site Supervisor understands that children shall be visually supervised at all times. LPA observed classrooms in order. Drinking water is readily available for the children in each room and in the outdoor playground area via drinking fountain. LPA observed solid waste containers with tight-fitting lids in each room. 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. Site Supervisor states that there are no weapons or firearms on the premises.

====CONTINUE IN LIC 809-C====

SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Elizabeth Larios
LICENSING EVALUATOR SIGNATURE: DATE: 04/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/09/2024
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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: FREEDOM CHILDREN'S CENTER
FACILITY NUMBER: 440703706
VISIT DATE: 04/09/2024
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LPA observed furniture and equipment in good condition and safe for the children. The playground areas utilized by children is surrounded by appropriate fencing. LPA did observed sufficient resilient materials under slides and other similar equipment, and surrounded area that should be cushioned with material that absorbs falls. LPA observed that the outdoor equipment is age appropriate. LPA did not observe any bodies of water.

Meals and snacks are delivered from Freedom Elementary School Kitchen. Food storage such refrigerator, and microwave areas are clean, free of litter & rubbish, and free of rodents and other vermin. LPA observed a fully charged 3A40BC fire extinguishers in each classroom and kitchen, and working smoke/carbon monoxide detectors and first aid kits. Site Supervisor states that the facility does administer medications at this time when needed.

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

Site Supervisor 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.


Exit interview conducted and report was reviewed with the Site Supervisor, Maria "Lupe Fernandez and Linda Orosco. Deficiency issued during today's inspection and appeal rights were given.

A NOTICE OF SITE VISIT WAS ISSUED, POSTED NEAR THE ENTRANCE TO THE FACILITY, AND MUST REMAIN POSTED FOR 30 DAYS.
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Elizabeth Larios
LICENSING EVALUATOR SIGNATURE:

DATE: 04/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/09/2024
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Document Has Been Signed on 04/10/2024 11:16 AM - It Cannot Be Edited


Created By: Elizabeth Larios On 04/09/2024 at 02:34 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: FREEDOM CHILDREN'S CENTER
FACILITY NUMBER: 440703706

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/09/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
WD
101700.3(b)(1)
Lead Testing Written Directives (b)(1) a result with values of 5.5 parts per billion or greater shall be deemed an Action Level Exceedance (ALE).

This requirement is not met as evidenced by:
Deficient Practice Statement
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After water lead testing was completed, the facility had one faucet (F) located in the kicthen with an Action Level Exceedance of 5.8, which poses a potenial risk to the health, safety, and personal rights of children in care.
POC Due Date: 04/16/2024
Plan of Correction
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The facility has completely replaced faucet "F" and retested and did not resloved the water lead ALE result. The facility will remove faucet "F" and notify Licensing once it has been remove by submitting plan of correction by POC due date 4/16/2024.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Joel Segura
LICENSING EVALUATOR NAME:Elizabeth Larios
LICENSING EVALUATOR SIGNATURE:
DATE: 04/09/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/09/2024


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