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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 444410738
Report Date: 01/29/2020
Date Signed: 01/29/2020 03:21:33 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:BRADLEY STATE PRESCHOOLFACILITY NUMBER:
444410738
ADMINISTRATOR:K.LATHROP/M.SERRANOFACILITY TYPE:
850
ADDRESS:321 CORRALITOS ROADTELEPHONE:
(831) 786-1872
CITY:WATSONVILLESTATE: CAZIP CODE:
95076
CAPACITY:22CENSUS: 11DATE:
01/29/2020
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
01:50 PM
MET WITH:M. Serrano & Karen HammanTIME COMPLETED:
03:30 PM
NARRATIVE
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LPA, Behbood made a visit to conduct an annual/Random visit. Met Manual Serrano, Site Supervisor, purpose of visit explained. Present also were 11 day care children and one additional staff. Program coordinator Karen Hamman arrived during visit. Random Staff and children files were reviewed.
All staff have clearances through board of education.
This facility provides Incidental Medical Services (IMS). LPA reviewed storage of medication and equipment /supplies, and reviewed children’s, personnel and administrative records. .
Operation hours are M through F from 8:30 to 11:30 and 12:15 to 3:15.
There are no bodies of water at the facility. Cleaning supplies are stored inaccessible to children .
Medication was stored in a locked box inaccessible to children in its original box.
Furniture & equipment appear in good condition. Floors appear clean. Children's bathrooms are in operating condition. Trash can for food waste has a tight fitting cover. Only snack is provided by the center. Menu is posted. Food in delivered from the Elementary School Kitchen,
Playground has climbing structures, sand boxes, etc. Sand & wood chips are used for cushioning material.
Drinking water inside the classrooms and in the playground is provided via water fountain.
Staff have current CPR & 1st aid cards. Staff files have copies of their educational background. Children's files have emergency information.
Children were supervised during the visit. Teacher/child ratio was met during the visit.
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: 01/29/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2020
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 2
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: BRADLEY STATE PRESCHOOL
FACILITY NUMBER: 444410738
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/29/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/30/2020
Section Cited

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Health Related Services - Prescription medications shall be administered in accordance with the label directions as prescribed by the child's physician. This requirement is not met by: The inhaler for C1
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expired in 12/2019, this potentially put child's health and safety of the child at risk.
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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: 01/29/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/29/2020
LIC809 (FAS) - (06/04)
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