350709612-1-24-2020-07-CC-DVIA-BL5RQY-20200124121419

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 350709612
Report Date: 01/24/2020
Date Signed: 01/24/2020 12:14:26 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:	HOLLISTER HEAD START		FACILITY NUMBER:	350709612
ADMINISTRATOR:	MARIBEL CORTEZ		FACILITY TYPE:	850
ADDRESS:	1011 LINE STREET		TELEPHONE:	(408) 637-8597
CITY:	HOLLISTER	STATE: CA	ZIP CODE:	95023
CAPACITY:	77	CENSUS:	DATE:	01/24/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:10 AM
MET WITH:	Rocio Little		TIME COMPLETED:	12:25 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), Deanna Villagrana, conducted an unannounced annual/random inspection to the Facility today. LPA met with Rocio Little, director, and explained the nature of today's visit to her. Rocio is not listed as Director in CCLD system but LPA will update records. LPA received required documents to complete. The Facility is licensed in the room 1, 2, 7 and 9 at Hollister ECE building. The playground area of the Facility is located in back of classrooms. The Facility has an active waiver that allows the inclusion of children in the Special Education Classrooms at the Hollister Head Start Site to share the playground space with children from your center. This facility is also regulated by the Department of Education, and the criminal background clearances are through them. LPA toured the Facility both inside and outside for today's inspection. 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, Menus, and Activity Schedule. LPA reviewed ten children's and four staff (4 teachers) files during today's inspection. All staff and children's files were complete. Two of the teachers have current CPR and First Aid certifications on file. All four staff files reviewed contain the required transcripts/verification of experience. Rocio 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). All staff have completed Mandated Reporter Training. LPA observed that the teacher/child ratio was in compliance during today's visit. LPA observed room 1 and 9 out in the playground with 28 children with two teachers, three aides and three special education teachers. LPA observed one teacher and two aides with 19 children and room 7 one teacher, two aides and 18 children. Rocio understands the conditions, limitations, and capacity specifications of the Facility license. Rocio understands that children shall be visually supervised at all times.

SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Deanna Villagrana	TELEPHONE: (408) 335-9890
LICENSING EVALUATOR SIGNATURE:	DATE: 01/24/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2020

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: HOLLISTER HEAD START	FACILITY NUMBER: 350709612
	VISIT DATE: 01/24/2020

NARRATIVE

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LPA observed that all rooms are clean and safe for all children and staff. Rocio states that the Facility is cleaned by Santa Clara County office of Education. Drinking water is readily available for the children in each room via water dispenser and outdoor playground area via water jug/disposable cups. LPA observed solid waste containers with tight-fitting lids in the Facility. Staff and children's bathrooms are clean, sanitary, and operable. There is a separate staff toilet not utilized by the children. Rocio states that there are no weapons or firearms on the premises.

The food preparation and storage areas are clean, free of litter & rubbish, and free of rodents and other vermin. All food and beverages that require refrigeration are stored in covered containers at 45 degrees F or less. Cleaning supplies are stored inaccessible to children. Any poisons are stored in janitors closet. Any medications at the Facility are stored in each classroom inaccessible to children. LPA observed the facility administers IMS for one child and all documents are up to date.

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 and the outdoor surfaces are safe for the children. LPA observed that the outdoor equipment is age appropriate and in good condition. Several trees and the canopies provide shade for the day care children. LPA did not observe any bodies of water.

LPA conducted an exit interview with the Rocio prior to the conclusion of today's visit. Licensing Forms, Title 22 Regulations, and information can be obtained through the internet at www.cdss.ca.gov.

No deficiencies were cited during visit.

A NOTICE OF SITE VISIT WAS ISSUED, POSTED NEAR THE FACILITY ENTRANCE, AND MUST REMAIN POSTED FOR 30 DAYS.

SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Deanna Villagrana	TELEPHONE: (408) 335-9890
LICENSING EVALUATOR SIGNATURE:	DATE: 01/24/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2020

LIC809 (FAS) - (06/04)

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