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Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
440709560
Report Date:
05/08/2019
Date Signed:
05/08/2019 02:17:16 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:
PAJARO VALLEY CHILDREN'S CENTER
FACILITY NUMBER:
440709560
ADMINISTRATOR:
ROSA MENDOZA
FACILITY TYPE:
850
ADDRESS:
234 MONTECITO STREET
TELEPHONE:
(831) 722-3737
CITY:
WATSONVILLE
STATE:
CA
ZIP CODE:
95076
CAPACITY:
24
CENSUS:
19
DATE:
05/08/2019
TYPE OF VISIT:
POC
UNANNOUNCED
TIME BEGAN:
01:00 PM
MET WITH:
Rosa Mendoza
TIME COMPLETED:
01:50 PM
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An unannounced visit was made by Analyst Behbood to follow up on citations issued during annual visit on 04/25/19.
The following were inspected:
Menu
Certificate of Training for Mandated Child Abuse
Tan Bark
Bicycles
The menu now have portion size and date
All staff took the training and now have certification for verification
The old and broken bike are disposed off.
Staff now use gloves when serving food. She stated she will buy serving utensils
Dishes are now being disinfected with mixture of water and Clorox
During the visit children were supervise.
All the citation except the painting of the boards are corrected now. Rosa Stated they are going to work on the painting this weekend. She will send a picture when the project is complete.
No additional citations issued.
SUPERVISOR'S NAME:
Anthony Studebaker
TELEPHONE:
(408) 324-2155
LICENSING EVALUATOR NAME:
Mahvash Behbood
TELEPHONE:
(408) 334-8552
LICENSING EVALUATOR SIGNATURE:
DATE:
05/08/2019
I acknowledge receipt of this form and understand my licensing appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
05/08/2019
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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