274414323-5-22-2023-07-CC-CNEN-CS3ST7-20230522140903

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 274414323
Report Date: 05/22/2023
Date Signed: 05/22/2023 02:09:16 PM

Document Has Been Signed on 05/22/2023 02:09 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:	OHLONE PRESCHOOL MIGRANT & SEASONAL HEAD START R#2		FACILITY NUMBER:	274414323
ADMINISTRATOR:	K.LATHROP/LETICIA G		FACILITY TYPE:	850
ADDRESS:	58 HILLCREST ROAD ROOM 2		TELEPHONE:	(831) 728-7897
CITY:	ROYAL OAKS	STATE: CA	ZIP CODE:	95076
CAPACITY:	23	CENSUS: 23	DATE:	05/22/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:01 AM
MET WITH:	Leticia Gomez & Maria Cortes		TIME COMPLETED:	02:20 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	Licensing Program Analyst (LPA), Cortney Nelson, met with Site Supervisor, Leticia Gomez, and Child Development Coordinator, Maria Cortes for an unannounced Required- 1 Year Inspection. LPA was granted access to the facility by staff member, Leticia, and toured both indoors and outdoors during the inspection. Upon arrival, there were twenty three (23) preschool-age children and five (5) staff members present, which is compliant with the facility license capacity and ratio requirements. LPA observed all required postings near the entrance to the facility and the hours of operation are Monday – Friday, 6:00AM-6:00PM. LPA reviewed sign-in/out sheets, facility roster (LIC9040), and fire/disaster drill log. The facility has not yet conducted a fire/disaster drill as services began 5/8/2023. LPA reminded drills should be conducted every six months. The facility has a waiver for legal guardian signature and LPA observed that all guardians have full signature this season. LPA observed a fully charged 3A40BC fire extinguisher, functioning smoke detector and carbon monoxide detector. Leticia states that there are children in care who require Incidental Medical Services (inhalers) and LPA observed that IMS medication is properly stored out of reach of children with the proper documentation. There are no weapons or firearms on the premises. This facility provides Incidental Medical Services- IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual- Regulation Interpretations and Procedures for Child Care Centers, Section 101173 and 101226. The following information regarding ADA was provided: US Department of Justice 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 Indoor areas were inspected by the LPA and observed to be clean, orderly, and safe for the day care children. Furniture, such as tables, chairs, and shelves, are in good condition and safe for children. The floors were clean and free of tripping hazards. Drinking water is readily available for children in the facility via water dispensers and disposable cups. Staff and children’s bathrooms are clean, sanitary, and operable. There is a separate staff bathroom, not utilized by the children, which an isolated child can use if necessary. There is a working telephone.

SUPERVISOR'S NAME: Joel Segura	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Cortney Nelson	TELEPHONE: (916) 956-5037
LICENSING EVALUATOR SIGNATURE:	DATE: 05/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2023

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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Document Has Been Signed on 05/22/2023 02:09 PM - It Cannot Be Edited

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: OHLONE PRESCHOOL MIGRANT & SEASONAL HEAD START R#2	FACILITY NUMBER: 274414323
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/22/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1597.16(a)(1)

Lead Testing

(1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on interview and record review, the licensee did not comply with the section cited above as the facility has not submitted water lead test results that follow the written directives, which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 05/31/2023
	Plan of Correction
1 2 3 4	The facility will submit a plan of correction that outlines when water lead testing will be completed to bring the site into compliance. LPA advised submitting prior water lead testing that has been completed, however did not meet the written directives criteria.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Joel Segura	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Cortney Nelson	TELEPHONE: (916) 956-5037
LICENSING EVALUATOR SIGNATURE:	DATE: 05/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2023

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: OHLONE PRESCHOOL MIGRANT & SEASONAL HEAD START R#2	FACILITY NUMBER: 274414323
	VISIT DATE: 05/22/2023

NARRATIVE

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The outdoor area was inspected and observed to be fenced in. There is a playground, sandbox, play house, and other materials located outside for children's use. LPA observed play equipment was in good condition, age-appropriate, and has sufficient resilient materials (rubber padding) to absorb falls. No outdoor bodies of water were observed during today’s inspection. Shaded rest area is provided by canopy and there are three (3) functioning sinks located outside.

Food is provided through Pajaro Valley Unified School District Food Program and is stored, prepared, and served in a safe and healthful manner to the children. The facility offers a full day program and provides breakfast, lunch, and AM/PM snack to children. Menu is in writing and posted at least one week in advance, accessible to authorized representatives.

Five (5) children’s files and five (5) staff files and all required documents were present. All staff have current CPR/First-Aid and the Site Supervisor's expires 4/5/2025. The Site Supervisor's Mandated Reporter Training expires on 8/3/2024. LPA reminded that both trainings must be renewed every 2 years.

Exit interview conducted and report was reviewed with the Child Development Coordinator, Maria Cortes.

As a result of today’s inspection, a deficiency was cited, see LIC809-D.

A NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 DAYS.

SUPERVISOR'S NAME: Joel Segura	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Cortney Nelson	TELEPHONE: (916) 956-5037
LICENSING EVALUATOR SIGNATURE:	DATE: 05/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2023

LIC809 (FAS) - (06/04)

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