153801890-6-15-2022-12-CC-EROZ-CFEP9N-20220615110725

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 153801890
Report Date: 06/14/2022
Date Signed: 06/15/2022 11:07:32 AM

Document Has Been Signed on 06/15/2022 11:07 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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME:	MILAGRO MIGRANT HEAD START		FACILITY NUMBER:	153801890
ADMINISTRATOR:	CRISTINA MACHUCA		FACILITY TYPE:	850
ADDRESS:	222 HOOD STREET		TELEPHONE:	(661) 854-3376
CITY:	ARVIN	STATE: CA	ZIP CODE:	93203
CAPACITY:	56	CENSUS: 16	DATE:	06/14/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:14 AM
MET WITH:	Cristina Machuca		TIME COMPLETED:	01:30 PM

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On 06/14/22 at 10:14 a.m. Licensing Program Analysts (LPA) Esequiel Rodriguez conducted an unannounced Annual Required inspection at the Milagro Migrant Head Start Center Facility to assess the Center's operation of their Infant Program and current physical plant status. Also, to evaluate the Center's continuing ability to meet compliance with California Code of Regulations (CCR) Title 22, Health and Safety requirements, and other applicable State and Licensing Statutory requirements. The LPA met with the Facility Center Supervisor, Cristina Machuca, stated the purpose for the inspection and provided a copy of the Entrance checklist form, LIC 125..

During the previous inspection the LPA only inspected the Physical Plant in which the entire physical plant met regulatory requirements. See LIC 809 report dated 05/16/22 for more.

The facility is licensed to provide child care services and education to, up to, 56 children ages two to six years old, and may accept up to 5 non-ambulatory children. Currently there are 15 children present in care. The Center Supervisor indicated she ensures the facility does not go over the capacity specified on the license.

The LPA conducted a review of several Staff records. The review included, but was not limited to the following: Criminal record statements (LIC 508) Record of submission of Child Abuse Index Checks. Staff qualification. Reference letters and verifying work experience on file. Health clearances, including TB clearances. Pediatric CPR/first aid cards for designated staff. 15 hours of health & safety training for designated Staff. Notice of Employee Rights receipts (LIC 9052). Statement Acknowledging Requirement to Report Suspected Child Abuse. (LIC 9108) and Mandated Reporter Training certificate. Copy of driver’s license. Personnel Record (LIC 501) or application/resume with required information.

SUPERVISOR'S NAME: Scott Herring	TELEPHONE: (661) 202-3314
LICENSING EVALUATOR NAME: Esequiel Rodriguez	TELEPHONE: (661) 202-3321
LICENSING EVALUATOR SIGNATURE:	DATE: 06/14/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2022

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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: MILAGRO MIGRANT HEAD START	FACILITY NUMBER: 153801890
	VISIT DATE: 06/14/2022

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A review of staff records on today's date indicates that the Center staff and other individuals listed on the LIC 500, Personnel Report and other personnel working at the Facility have received Criminal Record, FBI, DOJ and Child Abuse Central Index Check clearances or exemptions. However, this Facility is part of a chain Facility. Per Area Manager, Lupe Sanchez stated that they requested a Chain Facility - Central Administrative Facility Waiver to which all criminal record background checks are associated and it was approved. The Central Administrative office is Buena Vista Migrant Head Start Facility - 153801390. The LPA was not able to locate the approval waiver in FAS and provided technical advise regarding Chain Facilities.

Also, a review of several Children records was conducted. The review included, but was not limited to the following: Admission agreements. Needs and Services Plans for infants,. Immunization Records (“blue cards; PM 286) for non-school-age children. Authorizations for dispensing medications signed by parents. Identification and Emergency Information forms (LIC 700) Child’s Pre-admission Health History- Parents’ Report forms (LIC 702) Child’s Pre-admission Health Evaluations- Physician’s Report forms (LIC 701)
Documentation required for health-related services (e.g., blood-glucose monitoring, nebulizer care LIC 9166, gastrostomy-tube care LIC 701A and LIC 701B) Consent for Emergency Medical Treatment forms (LIC 627)
Unusual Incident/Injury or Death Reports (LIC 624) Parents’ Rights (LIC 995) receipts, signed and dated.
Personal Rights receipts (LIC 613), signed and dated.

At the time of the inspection, the LPA observed appropriate Staffing Ratio and Capacity: Staffing ratios per number of children in care was in compliance.

Per Center Supervisor and Staff interviewed all children in care are accorded with their Personal Rights. Each child in the facility receiving services is treated with dignity and respect and have certain rights that will never be waived or abridged by anyone providing services in the facility regardless of consent or authorization from the child's authorized representative. These rights include, but are not limited to, the following:
(1) To be treated with dignity in his/her personal relationship with staff and other persons.
(2) To receive safe, healthful, and comfortable accommodations, furnishings, and equipment.
(4) To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse, or other actions of a punitive nature, including, but not limited to: interference with eating, sleeping or toileting; or withholding shelter, clothing, medication or aids to physical functioning.

SUPERVISOR'S NAME: Scott Herring	TELEPHONE: (661) 202-3314
LICENSING EVALUATOR NAME: Esequiel Rodriguez	TELEPHONE: (661) 202-3321
LICENSING EVALUATOR SIGNATURE:	DATE: 06/14/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2022

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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: MILAGRO MIGRANT HEAD START	FACILITY NUMBER: 153801890
	VISIT DATE: 06/14/2022

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The Center Supervisor and staff are aware of Title 22 Reporting Requirements in accordance with Title 22 (101212) including to notify the Department in writing of his/her intent prior to making any structural changes that reduce the total amount of indoor or outdoor activity space. Such structural changes shall include, but not be limited to any physical plant addition. The Facility does not have an Infant/Toddler Component.

The LPA advise the Facility Supwervisor to become very familiar with the Guardian Background Check Program and Title 22, California Code of Regulations. The LPA provided information regarding where to locate Information Provider Notices (PINs) Training (e.g. Mandated Reporter) and how to access and subscribe to Child Care Licensing Quarterly Updates.

During today's inspection the LPA observed no deficiencies that may hinder the health and safety of the children in care. Therefore, no deficiencies were cited.

Overall, the Center is in compliance per Title 22 regulations, no deficiencies cited during this inspection.

An exit Interview was conducted and a copy of this Report, Children's Record Review form, LIC 857, Review of Staff Records form, LIC 859, Notice of Site Visit, LIC 9213 and LIC 9102 Technical Assistance were provided to Ms. Machuca.

SUPERVISOR'S NAME: Scott Herring	TELEPHONE: (661) 202-3314
LICENSING EVALUATOR NAME: Esequiel Rodriguez	TELEPHONE: (661) 202-3321
LICENSING EVALUATOR SIGNATURE:	DATE: 06/14/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2022

LIC809 (FAS) - (06/04)

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