274400409-8-2-2021-07-CC-SCES-C5HULQ-20210802154108

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 274400409
Report Date: 08/02/2021
Date Signed: 08/02/2021 03:41:14 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:	PRIMAVERA MIGRANT HEAD START		FACILITY NUMBER:	274400409
ADMINISTRATOR:	WILLIAM CASTELLANOS		FACILITY TYPE:	850
ADDRESS:	24228 LINCOLN STREET		TELEPHONE:	(831) 679-0503
CITY:	CHUALAR	STATE: CA	ZIP CODE:	93925
CAPACITY:	45	CENSUS: 17	DATE:	08/02/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:15 PM
MET WITH:	Graciela Garcia Ledesma		TIME COMPLETED:	03:45 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 08/02/2021 at 01:15 PM, Licensing Program Analyst (LPA), Susy Cervantes, conducted an unannounced annual visit to the Facility. LPA met with Graciela Garcia Ledesma and Edith Botello, director and family service advocate, and explained the nature of today’s visit. LPA toured the Facility both inside and outside during today’s 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), Menus, and Activity Schedule. LPA observed a disaster drill log that was conducted on 07/21/2021, A listing of staff criminal record clearances associated to this facility in the CCL Licensing Information System (LIS) on 08/02/2021 was reviewed; and it indicates that all Facility staff or other individuals who require caregiver background clearances have received criminal record and child abuse index clearances or exemptions. LPA also reminded them of the applicable civil penalties for those adults who have not received fingerprint clearance, 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. LPA observed the medical assessment and the Information and Emergency Information form (LIC 700) in 8 children’s files. LPA observed the required health screening in 5 staff files and CPR and First Aid on all five files that expires on 09/08/22 & 03/29/23. Director 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 (field trips). Director understands the conditions, limitations, and capacity specifications of the Facility license. Director understands that children shall be visually supervised at all times. *Continues on report dated 08/02/2021 pg. 1/2*

SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Susy Cervantes	TELEPHONE: (408) 598-9403
LICENSING EVALUATOR SIGNATURE:	DATE: 08/02/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/02/2021

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: PRIMAVERA MIGRANT HEAD START	FACILITY NUMBER: 274400409
	VISIT DATE: 08/02/2021

NARRATIVE

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Continuation of report dated 08/02/2021 pg. 2/2
LPA reviewed the sign-in, sign-out sheets for the past 30 days and took a picture of a Child Care Facility Roster (LIC 9040) and all were in compliance. LPA observed that the teacher/child ratio was in compliance during today’s visit. LPA observed 2 teachers with 12 children in the preschool classroom and three teachers with 5 children in the toddler classroom.

LPA observed that all rooms were clean and safe for all children and staff. Drinking water is readily available for the children in each room and in the outdoor playground area via water dispensers and cups. LPA observed solid waste containers with tight-fitting lids in each room and in the playground area. LPA observed three 2A10BC and one 3A40BC fire extinguishers that were last inspected on 03/18/2021. Carbon monoxide and smoke detectors were operable. Staff and children’s bathrooms were clean, sanitary, and operable. There was a separate staff bathroom not utilized by the children which an isolated child can use if needed. Director stated that there are no weapons on the premises.

The food preparation area is adequately equipped with ovens, refrigerators, and hot and cold running water. There is also adequate food for snacks and regular meals for the children. Cleaning supplies are inaccessible to the children and stored on top shelves. Director stated there are no poisons at the facility. Any medications at the Facility are stored appropriately and in medication boxes in each classroom.

LPA observed all furniture and equipment is in good condition and safe for the children. The playground area utilized by children is surrounded by appropriate fencing. The preschool and toddler playgrounds are separated by a fence. LPA observed that the outdoor equipment is age appropriate and in good condition. LPA did not observe any bodies of water.

LPA discussed Zero Tolerance with $500 civil penalty and the requirements of AB633 with the director, Graciela Garcia, and provided them the AB633 fact sheet and a copy of Acknowledgement of Receipt of Licensing Reports (LIC 9224) and they understand the requirements. Licensing Forms, Title 22 Regulations and Information can be obtained through the internet at www.cdss.ca.gov.

LPA conducted an exit interview with Director. No deficiencies cited during today's inspection. NOTICE OF SITE VISIT MUST BE POSTED FOR 30 DAYS.

SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Susy Cervantes	TELEPHONE: (408) 598-9403
LICENSING EVALUATOR SIGNATURE:	DATE: 08/02/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/02/2021

LIC809 (FAS) - (06/04)

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