350710320-1-16-2025-07-CC-PSGZ-DCYQU9-20250116112823

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 350710320
Report Date: 01/16/2025
Date Signed: 01/16/2025 11:28:35 AM

Document Has Been Signed on 01/16/2025 11:28 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME:	GO KIDS CLUB - RO HARDIN		FACILITY NUMBER:	350710320
ADMINISTRATOR/ DIRECTOR:	MITSY NAVARRO		FACILITY TYPE:	840
ADDRESS:	761 SOUTH STREET		TELEPHONE:	(831) 636-8171
CITY:	HOLLISTER	STATE: CA	ZIP CODE:	95023
CAPACITY: 56	TOTAL ENROLLED CHILDREN: 56	CENSUS: 0	DATE:	01/16/2025
TYPE OF VISIT:	Annual/Required	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:14 AM
MET WITH:	Viridiana Aguiniga & Mitsy Navarro		TIME VISIT/ INSPECTION COMPLETED:	11:40 AM

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 (LPAs), Pedro Solorio and Elizabeth Larios, conducted an unannounced required one year inspection to the Facility today. LPAs met with director, Mitsy Navarro and explained the nature of this visit to her. The Facility is licensed in portable room 1 and 2. LPAs notes that the facility has a license for a preschool program (354412143) at the facility. The playground area of the facility is located behind the portables. LPAs toured the Facility both inside and outside for today's inspection. LPAs 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. A review of staff records on 1/15/2022 indicates that not all Facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. Director Mitsy Navarro was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated. LPAs reviewed four children's and two staff (1 teacher, 1 Aide) files during today's inspection. All staff and children's files were complete. All staff have current CPR and First Aid and Mandated Reporter training certificates on file. All staff have immunization records on file. All staff files reviewed contain the required transcripts/verification of experience. Director Mitsy 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).

SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Pedro Solorio-Gutierrez
LICENSING EVALUATOR SIGNATURE:	DATE: 01/16/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2025

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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: GO KIDS CLUB - RO HARDIN	FACILITY NUMBER: 350710320
	VISIT DATE: 01/16/2025

NARRATIVE

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During inspections, no children were in care. Mitsy understands the conditions, limitations, and capacity specifications of the Facility license. Mitsy understands that children shall be visually supervised at all times. LPAs observed that room is clean and safe for all children and staff. Mitsy states that the facility has a janitorial service that come in the evenings to clean the facility. Drinking water is readily available for the children in each room and in the outdoor playground area via water container and disposable cups. LPAs 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 which an isolated child can use if needed. Mitsy 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 inaccessible to the children and stored in high cabinets inaccessible to children. Any poisons are stored in locked storage cabinets. Any medications at the facility are stored in a medicine box in a top cabinet in the off-limit kitchen area. No IMS is administered by the facility at this time.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. When any IMS is provided, a Plan for Providing 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: https://www.ada.gov/resources/child-care-centers/.

LPAs 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 (sand and tan bark) are safe for the children. LPAs observed that the outdoor equipment is age appropriate and in good condition. A gazebo and the building overhang provide shade for the day care children. LPAs did not observe any bodies of water.

SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Pedro Solorio-Gutierrez
LICENSING EVALUATOR SIGNATURE:	DATE: 01/16/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2025

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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: GO KIDS CLUB - RO HARDIN	FACILITY NUMBER: 350710320
	VISIT DATE: 01/16/2025

NARRATIVE

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To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1- CCP).

LPAs verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1.CCP.
LPAs referred Director Mitsy to the Department website for lead: Lead Toxicity Prevention and Water Testing Information.

LPAs discussed the safe sleep regulations with Director Mitsy and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPAs also informed Director Mitsy of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Director Mitsy was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with Director Mitsy Navarro.

SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Pedro Solorio-Gutierrez
LICENSING EVALUATOR SIGNATURE:	DATE: 01/16/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2025

LIC809 (FAS) - (06/04)

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