PACIFIC GROVE ADULT EDUCATION CDC

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25On September 24, 2025, Licensing Program Analyst (LPA) Darnella Barnes conducted an unannounced annual inspection. The purpose of the visit was explained to Director Jennifer Hall, who granted access to the facility and received the Entrance Checklist (LIC 125) The facility operates Monday – Friday 7:00am – 5:30pm, Required postings were visible to the public, and the last fire drill was completed on 8/29/25. Director was reminded of the six-month drill and documentation requirement. A fully charged 3A-40B-C fire extinguisher, was last serviced on 6/19/25 is available, along with working smoke and carbon monoxide detectors, and an operating telephone.Director was reminded that smoking is prohibited. Directorr confirmed there are no firearms on the property. Director, 2 teachers, 5 teacher aides and 27 children were present, meeting capacity and ratio requirements. Staff were attentive, actively engaged with children, and present in sufficient numbers to ensure proper supervision. Director is aware of the child illness regulation. Fingerprint clearances for individuals at this facility who require caregiver background checks are issued by State Department and/or County Office of Education and do not come under the jurisdiction of Community Care licensing Division. -----CONTINUED ON NEXT PAGES ----- NAME OF LICENSING PROGRAM MANAGER: Gladys Kuizon NAME OF LICENSING PROGRAM ANALYST: Darnella Barnes LICENSING PROGRAM ANALYST SIGNATURE: DATE: 09/24/2025 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/24/2025 This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC809 (FAS) - (06/04)Page: 1 of 5 FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form. DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies: Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care. Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care. PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency. CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given. CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity. PENALTY NOTICE GIVEN The statement

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25On September 24, 2025, Licensing Program Analyst (LPA) Darnella Barnes conducted an unannounced annual inspection. The purpose of the visit was explained to Director Jennifer Hall, who granted access to the facility and received the Entrance Checklist (LIC 125) The facility operates Monday – Friday 7:00am – 5:30pm, Required postings were visible to the public, and the last fire drill was completed on 8/29/25. Director was reminded of the six-month drill and documentation requirement. A fully charged 3A-40B-C fire extinguisher, was last serviced on 6/19/25 is available, along with working smoke and carbon monoxide detectors, and an operating telephone.Director was reminded that smoking is prohibited. Directorr confirmed there are no firearms on the property. Director, 2 teachers, 5 teacher aides and 27 children were present, meeting capacity and ratio requirements. Staff were attentive, actively engaged with children, and present in sufficient numbers to ensure proper supervision. Director is aware of the child illness regulation. Fingerprint clearances for individuals at this facility who require caregiver background checks are issued by State Department and/or County Office of Education and do not come under the jurisdiction of Community Care licensing Division. -----CONTINUED ON NEXT PAGES ----- NAME OF LICENSING PROGRAM MANAGER: Gladys Kuizon NAME OF LICENSING PROGRAM ANALYST: Darnella Barnes LICENSING PROGRAM ANALYST SIGNATURE: DATE: 09/24/2025 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/24/2025 This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC809 (FAS) - (06/04)Page: 1 of 5 FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form. DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies: Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care. Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care. PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency. CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given. CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity. PENALTY NOTICE GIVEN The statement

Type A citation - immediate risk to health, safety, or personal rights