444410610-12-8-2022-07-CC-CNEN-CLWTWG-20221208140530

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 444410610
Report Date: 12/08/2022
Date Signed: 12/08/2022 02:05:43 PM

Document Has Been Signed on 12/08/2022 02:05 PM - 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:	COMMUNITY BRIDGES FAIRGROUNDS CHILD DEV CENTER		FACILITY NUMBER:	444410610
ADMINISTRATOR:	AMY RATHER		FACILITY TYPE:	850
ADDRESS:	2667 EAST LAKE AVENUE		TELEPHONE:	(831) 786-9621
CITY:	WATSONVILLE	STATE: CA	ZIP CODE:	95076
CAPACITY:	45	CENSUS: 11	DATE:	12/08/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:22 AM
MET WITH:	Rosalba Torres & Lisa Hindman Holbert		TIME COMPLETED:	02:15 PM

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 Analyst (LPA), Cortney Nelson, met with the Site Director, Rosalba Torres, and the Licensee, Lisa Hindman Holbert, for an unannounced Required- 1 Year Inspection. The facility is located in a building at the Santa Cruz County Fairgrounds. LPA was granted access to the facility by the Site Director and toured both indoors and outdoors during the inspection. Upon arrival, there were 11 preschool-age children, the Site Director, and a teacher (Esmeralda) present, which is compliant with the license capacity and Title 5 ratio requirements. LPA observed all required postings near the entrance to the facility and the hours of operation are Monday – Friday, 8:00AM-4:00PM. LPA reviewed sign-in/out sheets, facility roster (LIC9040), and fire/disaster drill log during today’s inspection. Sign-in/out was observed to be completed with full legal signature and time of day. The last fire/disaster drill was conducted on 11/16/2022, which is compliant with the six-month requirement for facilities. LPA observed three (3) 2A10BC fire extinguishers (last serviced: 10/2020), functioning smoke detector and carbon monoxide detector. The Site Director states that she does not currently have any children in care who require Incidental Medical Services and does not administer medication at this time. There are no weapons or firearms on the premises and the facility has a working telephone. Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual- Regulation Interpretations and Procedures for Child Care Centers, Section 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

SUPERVISOR'S NAME: Joel Segura	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Cortney Nelson	TELEPHONE: (916) 956-5037
LICENSING EVALUATOR SIGNATURE:	DATE: 12/08/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/08/2022

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
	VISIT DATE: 12/08/2022

NARRATIVE

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Indoor areas of the facility were inspected by the LPA today and observed to be clean, orderly, and safe for the day care children. LPA observed children engaging in small group activities both inside and outside of the facility today, such as arts & crafts, puzzles, and playing with toys. Furniture, such as tables, chairs, and shelves, are in good condition and safe for children. The floors were clean and free of tripping hazards. Drinking water is readily available for children in the facility via water bottles and disposable cups. Staff and children’s bathrooms are clean, sanitary, and operable. There are separate staff bathrooms, not utilized by the children, which an isolated child can use if necessary.

The outdoor area of the facility was inspected and observed to be fenced in. There are a variety of activities for children to engage in such as swings, climbing structures, garden, maintained sandbox, and bikes. LPA observed most play equipment was in good condition, age-appropriate, and has sufficient resilient materials (rubber padding/sand) to absorb falls. LPA advised that playground located outside for children needs to be cleaned and repaired- the stairs have visible rusting, there is dirt built up on the climbing structure, and overall poses a potential hazard to children. No outdoor bodies of water were observed during today’s inspection. Shaded rest area is provided for children by canopy.

The facility works with Community Bridges food program and all food is prepared in a off-site central kitchen and brought during meal times. Smaller items, such as fruit & salad, are prepared at the facility in a safe and healthful manner for the children. The facility offers a full day program and provides breakfast, lunch, and PM snack to children. LPA advised that any extra food that will be used at a later date is properly sealed and labeled with the date opened and expiration date. The menu is in writing and posted at least one week in advance, accessible to authorized representatives. The kitchen and storage area is clean and free of litter and rubbish.

Five (5) preschool-age children’s files were reviewed during today’s inspection and all required documents were present. Three (3) staff files were reviewed and most required documents were present. There is at least one staff member present with current CPR/First-Aid that expires 12/16/2023 and current Mandated Reporter Training that expires on 12/2/2024. LPA reminded the Licensee that the Mandated Reporter Training must be renewed by all staff every 2 years. All staff at the facility are fingerprint cleared and associated to Community Bridges- Sycamore Street Early Education Center (#444400415). LPA advised Lisa of the necessary license updates for central fingerprint associations and reminded her of the conditions, such as quarterly submission of personnel roster (LIC500).

SUPERVISOR'S NAME: Joel Segura	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Cortney Nelson	TELEPHONE: (916) 956-5037
LICENSING EVALUATOR SIGNATURE:	DATE: 12/08/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/08/2022

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
	VISIT DATE: 12/08/2022

NARRATIVE

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The Licensee was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

The Licensee understands that the Site Director shall be on the premises during the hours the center is in operation and that children at the center shall be visually supervised at all times. LPA reminded the Licensee that there shall be at least one person with valid CPR and First-Aid certifications on site at all times or present during off site activities, such as field trips.

Exit interview conducted and report was reviewed with the Licensee, Lisa Hindman Holbert.

As a result of today’s inspection, deficiencies were cited, see 809-D.

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

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

LPA requested updated copies of the following forms:
-Application for a Child Care Center (LIC200A)
-Designation of Responsibility (LIC308) for Rosalba
-Board Resolution from Community Bridges, indicating Rosalba in charge of facility and able to act on licensing related matters
-Administrative Organization (LIC309) for Community Bridges
-Letter indicating which facilities should be associated to CB-Sycamore Street

SUPERVISOR'S NAME: Joel Segura	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Cortney Nelson	TELEPHONE: (916) 956-5037
LICENSING EVALUATOR SIGNATURE:	DATE: 12/08/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/08/2022

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 12/08/2022 02:05 PM - It Cannot Be Edited

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: 12/08/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101238(a)

Buildings and Grounds

(a) The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation and interview, the licensee did not comply with the section cited above for outside playground structure that needs cleaning/stair rust repair and electrical outlets with no covers inside the facility, which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 12/22/2022
	Plan of Correction
1 2 3 4	The Licensee will clean the playground of all visible dirt, repair the rusted stairs, and purchase/install electrical outlet covers for those missing one by 12/22/2022. Photographs of all repairs will be submitted to the Department by 12/22/2022.

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, interview, and record review, the licensee did not comply with the section cited above for one (1) out of three (3) staff present, which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 12/16/2022
	Plan of Correction
1 2 3 4	The Licensee will submit updated proof of completion for Mandated Reporter training for staff member missing it by 12/16/2022. LPA advised that it is for Child Care Providers (AB1207) www.mandatedreporterca.com

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	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Cortney Nelson	TELEPHONE: (916) 956-5037
LICENSING EVALUATOR SIGNATURE:	DATE: 12/08/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/08/2022

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 12/08/2022 02:05 PM - It Cannot Be Edited

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: 12/08/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101212(b)

Reporting Requirements

(b) The name of the child care center director, and any fully qualified teacher(s) designated to act in the child care center director's absence, shall be reported to the Department within 10 days of a change of child care center director or designee(s). This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, interview, and record review, the licensee did not comply with the section cited above as the former Site Director, Amy Rather, is no longer with the facility and was not reported to the Department, which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 01/13/2023
	Plan of Correction
1 2 3 4	The Licensee will submit all required documents for Rosalba Torres to be designated as the new Site Director at the facility. LPA advised of missing documents and provided list to the Licensee and advised it is submitted by 1/13/2023.

Type B

Section Cited

CCR

101227(a)(1)

Food Service

(1) All food shall be safe and of the quality and in the quantity necessary to meet the needs of the children. Each meal shall include, at a minimum, the amount of food components as specified by Title 7, Code of Federal Regulations, Part 226.20, (Revised January 1, 1990) Requirements for Meals, for the age group served. All food shall be selected, stored, prepared and served in a safe and healthful manner. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation and interview, the licensee did not comply with the section cited above as leftover food to be later served to children was unlabeled with date or expiration date and not properly sealed, which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 12/16/2022
	Plan of Correction
1 2 3 4	The Licensee will go through the kitchen fridge and pantry and properly label any food items that will be later served to children. Food should be labeled with the day it was served, expiration date, and staff initials. Photos of labeled and stored food should be submitted to the Department by 12/16/2022.

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	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Cortney Nelson	TELEPHONE: (916) 956-5037
LICENSING EVALUATOR SIGNATURE:	DATE: 12/08/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/08/2022

LIC809 (FAS) - (06/04)

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