440703702-12-21-2023-07-CC-CNEN-CYQQHA-20231221111050

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 440703702
Report Date: 12/21/2023
Date Signed: 12/21/2023 11:10:57 AM

Document Has Been Signed on 12/21/2023 11:10 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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME:	WATSONVILLE CHILDREN'S CENTER		FACILITY NUMBER:	440703702
ADMINISTRATOR:	ANTONETTE RECINOS		FACILITY TYPE:	850
ADDRESS:	32 MADISON STREET		TELEPHONE:	(831) 728-6280
CITY:	WATSONVILLE	STATE: CA	ZIP CODE:	95076
CAPACITY: 90	TOTAL ENROLLED CHILDREN: 79	CENSUS: 21	DATE:	12/21/2023
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Lisa Sandoval & Antonette Recinos		TIME COMPLETED:	11:20 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 Analysts (LPAs), Cortney Nelson and Liridon "Doni" Fici, met with Administrator, Lisa Sandoval, to follow-up on incident that was self reported to the Department on 12/11/2023. Upon arrival, LPAs were admitted into the facility office and notified Lisa of their arrival. Antonette arrived approximately 10 minutes after LPAs arrived to the facility. On 12/11/2023, Lisa called the Department to notify that C1 was left inside of a classroom while the rest of the class went outside. The child was noticed by a custodian (S1) present at the facility and was returned to the class outside by S2. Lisa states that the child was in the classroom alone for approximately ten (10) minutes prior to being found. On that day there were three staff members present (S2, S3, S4) with a census of seventeen (17) children. Lisa submit written testimony to the Department from all staff members involved in the incident. Review of the testimonies aligns with self-reported incident from the facility. Lisa further states that she has notified the assistant superintendent and HR of the incident and submitted unusual incident reports regarding it. Lisa conducted follow-up with the staff involved and trained all Site Supervisors on active supervision and reminders of proper protocol and procedures at the facility. There is a future training planned for all staff members as well. LPAs toured WCC3, where the incident occurred, and Lisa advised that staff shall count children prior to exiting the classroom and again before entering the fenced playground area. On the day of the incident, staff admitted that a second count was not taken prior to children being taken out to the playground. Lisa stated that staff know the office and custodian closet, located in the classroom, shall remain locked at all times while children are present. Keys to unlock the locked doors are hung next to the door for easy staff accessibility while children are present. Lisa further states that the office was not locked as the child was found in the office playing with paper. LPAs advised consideration for handles that are always locked from the outside or locks with a pin pad for the office and custodian closet.

SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Cortney Nelson
LICENSING EVALUATOR SIGNATURE:	DATE: 12/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/21/2023

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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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: WATSONVILLE CHILDREN'S CENTER	FACILITY NUMBER: 440703702
	VISIT DATE: 12/21/2023

NARRATIVE

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LPAs were advised that C1 has a history of hiding from staff and was likely hiding as the staff were transitioning to outside play. It is the responsibility of the staff to maintain visual supervision of children at all times, especially for those who are known to hide. Lisa states that she has reminded her staff of the importance of head counts and paying extra attention to those who may hide or otherwise have challenges associated with transitions.
LPAs informed licensee (Lisa Sandoval) that this report dated (12/21/2023) documents one Type A citation which shall be posted for 30 consecutive days as there is immediate risk to the health, safety, or personal rights of children in care.

Also, LPAs informed the licensee to provide a copy of this licensing report dated (12/21/2023) that documents any Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

As a result of today's inspection, deficiencies were cited, see LIC809-D. Civil penalties were not cited as government entities are exempt per CA CCR Section 101197.

Exit interview was conducted and report was reviewed with Administrator, Lisa Sandoval, and Site Director, Antonette Recinos.

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

SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Cortney Nelson
LICENSING EVALUATOR SIGNATURE:	DATE: 12/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/21/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 12/21/2023 11:10 AM - It Cannot Be Edited

Created By: Cortney Nelson On 12/21/2023 at 10:21 AM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

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

FACILITY NAME: WATSONVILLE CHILDREN'S CENTER	FACILITY NUMBER: 440703702
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 12/21/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 12/22/2023 Section Cited CCR 101229(a)(1)	1 2 3 4 5 6 7	101229 Responsibility for Providing Care and Supevision (a) The licensee shall provide care and supervision as necessary to meet the children's needs. (1) No child(ren) shall be left without the supervision of a teacher at any time.. supervision shall include visual observation. This requirement was not met as evidenced by:	1 2 3 4 5 6 7	The Licensee has conducted follow-up with staff involved, additional trainings will be conducted, there have been changes to the classroom procedures, and a UIR has been submitted to the Department. Meetings have taken place with HR and appropriate actions are being taken.
	8 9 10 11 12 13 14	The Licensee did not ensure that children are visually supervised at all times as a child was left in the classroom unsupervised for approximately 10 minutes which poses an immediate risk to the health, safety, and personal rights of children in care.	8 9 10 11 12 13 14	-No civil penalities issued, government entities exempt-
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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

LICENSING EVALUATOR NAME:

Cortney Nelson

LICENSING EVALUATOR SIGNATURE:

DATE: 12/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/21/2023

LIC809 (FAS) - (06/04)

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