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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 444410610
Report Date: 12/18/2019
Date Signed: 12/18/2019 01:03:19 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: 18DATE:
12/18/2019
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:MargaritaTIME COMPLETED:
01:10 PM
NARRATIVE
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A case management visit was made to follow up on deficiency cited during pervious visit. Site Supervisor Amy Rather was out of facility attending a training. Met Margarita, Lead teacher. Purpose of visit explained. Facility was toured. Children observed during lunch. The toilet is still not fixed. Margarita said Amy wanted analyst to call her so she can explain why the toilet is not fixed. It was explained that she should have called analyst to explain prior to my visit. Margarita explained that they sanitized dishes in the sink with Clorox after lunch, but this correction is not satisfactory as the sink is very old with lots of unknown stains. The sanitation must be done after washing the dishes in the sink in a separate container.
Please see re-citation of the pervious citations.
SUPERVISOR'S NAME: Anthony StudebakerTELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Mahvash BehboodTELEPHONE: (408) 334-8552
LICENSING EVALUATOR SIGNATURE:

DATE: 12/18/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2019
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: 12/18/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/10/2020
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
01/10/2020
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, during today's visit staff stated they do sanitize but there was no evidence that this is bing done. 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: 12/18/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/18/2019
LIC809 (FAS) - (06/04)
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