376700061-12-9-2021-10-CC-OCAN-C9JPPU-20211209103007

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376700061
Report Date: 12/09/2021
Date Signed: 12/09/2021 10:31:20 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME:	MAAC PROJECT HEAD START NORTH COAST		FACILITY NUMBER:	376700061
ADMINISTRATOR:	TRACEY ASTORGA		FACILITY TYPE:	850
ADDRESS:	1501 KELLY STREET		TELEPHONE:	(760) 966-7135
CITY:	OCEANSIDE	STATE: CA	ZIP CODE:	92054
CAPACITY:	60	CENSUS: 0	DATE:	12/09/2021
TYPE OF VISIT:	Office	UNANNOUNCED	TIME BEGAN:	09:49 AM
MET WITH:	Linda Hernandez- Area Manager		TIME COMPLETED:	10:33 AM

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An Informal Conference was held in the Riverside Regional Office South East- on this date, December 9th 2021, Present in the conference were Area Managers Linda Hernandez and Krystel Sanchez Licensing Program Manager (LPM), Pauline Beschorner, and Licensing Program Analyst (LPA) Otsanya Cameron.

The Conference was called to discuss the facility's most recent issues of Title 22 Regulations pertaining:
1. Personal Rights ( and employee training thereof)the licensee did not ensure the personal rights of a child in care was met;
2. Health-Related Services (Reporting Requirements)Facility director did not ensure the authorized representative was notified of an injury.
Pauline Beschorner reviewed with the Director the facilities recent deficiencies:

On 09/27/2021, the facility was cited for 101223(a)(3) Personal Rights.

On 9/30/2021, the facility was cited for 101226(a)(2) Health-Related Services.

LPM Beschorner spoke to the Director about the recent deficiencies and ways in which to prevent deficiencies in the future. The Area Manager stated the incident involved staff was written up and since trained on a zero tolerance policy

As a result of the informal conference, the Facility will complete and understand the following:

1. Facility agrees to continue training regarding Personal Rights and Health related services and reporting requirements.

SUPERVISOR'S NAME: Pauline Beschorner	TELEPHONE: (951) 782-6641
LICENSING EVALUATOR NAME: Otsanya Cameron	TELEPHONE: (951) 970-1388
LICENSING EVALUATOR SIGNATURE:	DATE: 12/09/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2021

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, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: MAAC PROJECT HEAD START NORTH COAST	FACILITY NUMBER: 376700061
	VISIT DATE: 12/09/2021

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The last training was signed by staff on 9/27/21 and will continue training annually or as needed program wide. All staff trained on Children's safety, Safe redirection, ouch reports, personal rights and supervision.

The Area Manager stated she understood what was discussed during the conference and has agreed to operate the facility in substantial compliance with all Title 22 regulations and Health and Safety codes.

Exit Interview was conducted with Linda Hernandez and a copy of this report was provided on this date.

SUPERVISOR'S NAME: Pauline Beschorner	TELEPHONE: (951) 782-6641
LICENSING EVALUATOR NAME: Otsanya Cameron	TELEPHONE: (951) 970-1388
LICENSING EVALUATOR SIGNATURE:	DATE: 12/09/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2021

LIC809 (FAS) - (06/04)

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