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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 270710406
Report Date: 03/29/2022
Date Signed: 05/19/2022 02:35:49 PM


Document Has Been Signed on 05/19/2022 02:35 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:SHERWOOD STATE / MIGRANT PRESCHOOL CHILD CAREFACILITY NUMBER:
270710406
ADMINISTRATOR:GONZALEZ, ERNESTOFACILITY TYPE:
850
ADDRESS:110 SOUTH WOOD STREETTELEPHONE:
(831) 784-5402
CITY:SALINASSTATE: CAZIP CODE:
93905
CAPACITY:44CENSUS: 12DATE:
03/29/2022
TYPE OF VISIT:OfficeANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Denise Noel TIME COMPLETED:
01:30 PM
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Licensing Program Manager (LPM), Joel Segura, and Licensing Program Analyst (LPA), Elizabeth Larios, met with Preschool Program Coordinator, Denise Noel via Zoom today for a scheduled Informal Meeting.The purpose of today's meeting is to discuss the following issue:

This informal conference is a direct result of recent type A citation:
09/14/2021 - Section 101229(a)(1)- Care and Supervision - Based on the self reported incident report, child (C-1) walked out onto the side walk located in the school parking lot near the fence of the school. Child (C-1) was left without direct supervision for a short period of time and found and redirected by parent back to teacher on 8/30/2021. Per 101197 (a) Civil Penalties shall not be assessed against any governmental entity including a state or city, holding a child care center license.

The facility implemented the following plan to bring the facility in compliance:
1) Staff will be outside during pick up time to supervise students.
2) Staff will have students line along the fence to ensure they do not leave the site until the parent has arrived and signed the child out.
3) Preschool Program Coordinator will monitor weekly to ensure the procedure is being followed and all students are safely being picked up.

Preschool Program Coordinator agreed to increase supervision and provide ongoing staff training on care and supervision, and positioning of staff. Training agenda and proof of attendance shall be maintained at facility for Community Care Licensing review.
CONTINUED ON LIC 809-C
SUPERVISOR'S NAME: Joel SeguraTELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Elizabeth LariosTELEPHONE: (408) 497-9236
LICENSING EVALUATOR SIGNATURE:
DATE: 03/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/29/2022
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: SHERWOOD STATE / MIGRANT PRESCHOOL CHILD CARE
FACILITY NUMBER: 270710406
VISIT DATE: 03/29/2022
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LPM explained to Preschool Program Coordinator that if there are continued deficiencies cited for the issue noted on this report, the facility may be referred to legal department for possible administrative action, which could include revocation of the facility license. The facility will be monitored for the next twelve months to ensure that the facility is in compliance with the Department regulations.

Assembly Bill 633 (Child Care Parent Notification Requirements) and Acknowledgement of Receipt of Licensing Report (LIC 9224) was also explained and provided to Preschool Program Coordinator during today’s meeting.

Signatures are available on hard copy.
SUPERVISOR'S NAME: Joel SeguraTELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Elizabeth LariosTELEPHONE: (408) 497-9236
LICENSING EVALUATOR SIGNATURE:

DATE: 03/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/29/2022
LIC809 (FAS) - (06/04)
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