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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 440703702
Report Date: 10/03/2019
Date Signed: 10/08/2019 01:47:07 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:WATSONVILLE CHILDREN'S CENTERFACILITY NUMBER:
440703702
ADMINISTRATOR:K.LATHROP/C.GUTIERREZFACILITY TYPE:
850
ADDRESS:32 MADISON STREETTELEPHONE:
(831) 728-6280
CITY:WATSONVILLESTATE: CAZIP CODE:
95076
CAPACITY:90CENSUS: DATE:
10/03/2019
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Vanessa Garcia and Karen HammanTIME COMPLETED:
03:15 PM
NARRATIVE
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Licensing Program Analyst (LPA), Elizabeth Berumen, conducted an unannounced case management inspection to the Facility in response to an Unusual Incident that the Facility self reported to the San Jose Regional Office (SJRO). LPA met with Site Supervisor, Vanessa Garcia and Child Development Coordinator, Karen Hamman and explained the nature of today's visit to them.

The Facility reported the Unusual Incident to SJRO on September 23, 2019. On Thursday, 09/19/19, she observed teacher 1 grab child 1 by the upper arm area that is close to the armpit and pulled the child. The child was knocking some toy blocks, so the Teacher grabbed her by the arm and told her to stop. Administrator intervened.
Child's parents were notified.

Based on LPA's interviews which were conducted and record review, the preponderance of evidence standard has been met, therefore California Code of Regulations, (Title 22, Division 12 & Chapter 1), is being cited on the attached LIC. 9099D.”

A notice of site visit was issued and posted near the facility entrance along with the Type "A" citation and both notices must remain posted for 30 consecutive days. The Licensee must provide copies of this report to parents/guardians of children in care at this facility and to parents/guardians of children newly enrolled at this facility during the next 12 months.
SUPERVISOR'S NAME: Mary SeguraTELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Elizabeth BerumenTELEPHONE: (408) 318-1326
LICENSING EVALUATOR SIGNATURE:

DATE: 10/03/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2019
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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/03/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/17/2019
Section Cited

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Personal Rights. Each child shall be free from corporal or unusual punishment, humiliation, intimidation, ridicule, coercion, threat, mental abuse, or other actions of a punitive nature. This requirement was not met as
evidenced by:
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A teacher grabbed a preschool child 1 by the arm and pulled child towards her. This is an immediate Health & Safety Risk to children in care.
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Upon receipt, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months.

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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: Mary SeguraTELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Elizabeth BerumenTELEPHONE: (408) 318-1326
LICENSING EVALUATOR SIGNATURE:
DATE: 10/03/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/03/2019
LIC809 (FAS) - (06/04)
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