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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 444410610
Report Date: 11/06/2019
Date Signed: 11/06/2019 01:42:41 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:COMMUNITY BRIDGES FAIRGROUNDS CHILD DEV CENTERFACILITY NUMBER:
444410610
ADMINISTRATOR:AMY RATHERFACILITY TYPE:
850
ADDRESS:2667 EAST LAKE AVENUETELEPHONE:
(831) 786-9621
CITY:WATSONVILLESTATE: CAZIP CODE:
95076
CAPACITY:45CENSUS: 21DATE:
11/06/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
11:50 AM
MET WITH:Amy RatherTIME COMPLETED:
01:55 PM
NARRATIVE
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LPA, Behbood made a visit to conduct an annual/Random visit. Met Am Rather, Site Supervisor, purpose of visit explained, Present also were 4 additional staff and 21 children. Staff and children files were reviewed. This is Title 5 program and certifies staff are finger printed through Dept of Education. Operation hours is M-F from 8 to 4, year around,
Incidental Medical Services were discussed with the licensee. The licensee is not providing IMS (Incidental Medical Services) at this time.
There are no bodies of water at the facility. Ms. Rather states there are no weapons at the Preschool.
Cleaning supplies are stored in the kitchen inaccessible to children .
None of the children are currently on any type of Medication.
Furniture & equipment appear in good condition.
Preschool refrigerator appears clean & all food is covered. Trash can for food waste has a tight fitting cover. Food is prepared at a central kitchen and delivered to facility, kitchen is inaccessible to children. Menu is posted
Playground has climbing structures, sand boxes, etc. Sands and tan barks are used for cushioning material.
Drinking water inside and outside the classrooms are provided via water dispenser.
There is no change in the staffing since last visit. Staff have current CPR & 1st aid cards. Children's files have emergency information.
Children were supervised during the visit. Teacher/child ratio was met during the visit.
Sign in and out sheet are signed properly by parents/child representative.
The roof has been replaced and the facility has been painted, so overall the physical part of the facility is in much better shape than it use to be.
Please see next page for citation under Title 22.
SUPERVISOR'S NAME: Anthony StudebakerTELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Mahvash BehboodTELEPHONE: (408) 334-8552
LICENSING EVALUATOR SIGNATURE:

DATE: 11/06/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2019
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: COMMUNITY BRIDGES FAIRGROUNDS CHILD DEV CENTER
FACILITY NUMBER: 444410610
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/06/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/08/2019
Section Cited

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Fixtures, Furniture, Equipment and Supplies. All toilets, hand-washing and bathing facilities shall be kept in safe and sanitary operation and shall be ADA compliant. This requirement is not met as evidenced by one toilet is not operating properly and another toilet had feces on the outside rim. This poses a potential risk to the health and safety of the children in care.

Type B
11/08/2019
Section Cited

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Food Services - Centers not using dishwashing machines shall clean and sanitize dishes and utensils by an alternative comparable method.
This requirement is not met as evidenced by Director's admission that dishwasher is not being used and they haven't been sanitizing dishes after each use. This pose
a potential risk to the health and safety of the children in care.

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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: Anthony StudebakerTELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Mahvash BehboodTELEPHONE: (408) 334-8552
LICENSING EVALUATOR SIGNATURE:
DATE: 11/06/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/06/2019
LIC809 (FAS) - (06/04)
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