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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 274400200
Report Date: 08/12/2019
Date Signed: 08/12/2019 01:46:05 PM

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:VALLE VERDE MIGRANT HEAD STARTFACILITY NUMBER:
274400200
ADMINISTRATOR:TRUJILLO, MARTHAFACILITY TYPE:
850
ADDRESS:490 EL CAMINO REALTELEPHONE:
(831) 674-0290
CITY:GREENFIELDSTATE: CAZIP CODE:
93927
CAPACITY:76CENSUS: 49DATE:
08/12/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
10:35 AM
MET WITH:Martha TrujilloTIME COMPLETED:
02:00 PM
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Licensing Program Analyst (LPA), Fermin Campos-Jaramillo, made an unannounced annual random inspection to the center today. LPA met with Martha Trujillo, Site Director, and explained the nature of today's inspection to her. The head start program is located in the Mary Chapa Literacy and Technology Academy in four classrooms. LPA observed a total of 49 preschool children were present in the classrooms. LPA observed there were 14 staff members taking care of the children. LPA observed that at least one staff members present during the inspection has current CPR/First Aid certifications. LPA observed the teacher-child ratio was in compliance with regulations. LPA observed posted the forms required by this Licensing Department.

LPA toured the facility inside and outside. Staff and children's toilets and sinks are safe and in sanitary operating conditions. LPA observed the storage areas are clean and free of litter. LPA observed disinfectants, cleaning solutions, sharp objects, and other similar items are stored inaccessible to children. LPA observed there is a first aid kit in each classroom in use and kits are inaccessible to children. Ms Trujillo stated the center provides meals and snacks and the menu is posted visible. Ms. Trujillo stated meals are prepared in the main facility in King City, and only snacks are prepared in the center. LPA observed the snack preparation area is equipped with microwave oven, sink and refrigerator. LPA observed each classroom has at least one functioning smoke detector and a fire extinguisher type 2A10BC. LPA observed that drinking water is readily available indoor via bottled water and disposable cups. LPA observed there are trash cans with tight fitting covers for the disposal of solid waste. LPA observed the center has a Carbon Monoxide detector in each classroom.
Ms. Trujillo states there are no weapons in the premises. The outdoor areas are surrounded with appropriate fencing and not bodies of water. LPA observed that all furniture, equipment and playground equipment is safe and in good conditions, free of sharp, loose, or pointed parts. LPA observed that shade in the playground is provided by tarps and trees.
REPORT DATED 8/12/2019 CONTINUES ON PAGE #2
SUPERVISOR'S NAME: Mary SeguraTELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Fermin Campos-JaramilloTELEPHONE: 408-334-8557
LICENSING EVALUATOR SIGNATURE:

DATE: 08/12/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2019
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 2
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: VALLE VERDE MIGRANT HEAD START
FACILITY NUMBER: 274400200
VISIT DATE: 08/12/2019
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Report dated 8/12/2019 continues from page 1.
LPA observed synthetic turf as resilient material under the climbing structures in the playground. LPA observed all floors were clean and safe. LPA observed that a fire drill was documented on 7/09/2019 LPA obtained a complete copy of the children's roster.
LPA reviewed 10 children's files for the Information and Emergency Information form. LPA reviewed the sign-in, sign-out sheets and are signed with full signatures. LPA observed there was a medical assessment document and a preadmission health history document in each child’s record. LPA observed there are records in each personnel file documenting the educational background of the staff.
LPA observed on report dated 8/09/2019 that all the adults in contact with children have received criminal records or exemptions. LPA reminded Ms. Trujillo of the applicable civil penalties for those adults who have not received fingerprint clearances, are not associated to the license and who come in contact with or provide care and supervision to the children. Penalty amounts: $100.00 per person per day, minimum of $100.00 to a maximum of $500.00 per person for an initial violation and a minimum of $100.00 to a maximum of $3000.00 per person for any subsequent violations within a 12-month-period.

Ms. Trujillo stated there are not children under medication currently enrolled in the center. For Incidental Medical Services (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.
LPA observed that all the staff members in contact with children have obtained proof of completion of the mandated reporter training (AB1207). LPA referred Ms. Trujillo to the Department website: www.ccld.ca.gov for additional information.
No Deficiencies were cited today.
Exit interview was conducted with Ms Trujillo. Licensee's Rights was printed and provided to Director.

NOTICE OF SITE VISIT WAS ISSUED AND MUST REMAIN POSTED FOR 30 DAYS.
SUPERVISOR'S NAME: Mary SeguraTELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Fermin Campos-JaramilloTELEPHONE: 408-334-8557
LICENSING EVALUATOR SIGNATURE:

DATE: 08/12/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2019
LIC809 (FAS) - (06/04)
Page: 2 of 2