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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 483001191
Report Date: 09/11/2019
Date Signed: 09/11/2019 03:52:41 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office,
, CA
FACILITY NAME:HEAD START - VIRGINIAFACILITY NUMBER:
483001191
ADMINISTRATOR:L.SMITH,J.EDWARDS,G.GARROTFACILITY TYPE:
850
ADDRESS:1328 VIRGINIATELEPHONE:
(707) 645-0634
CITY:VALLEJOSTATE: CAZIP CODE:
94590
CAPACITY:37CENSUS: 25DATE:
09/11/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:40 PM
MET WITH:Nicole Aurocha and TIME COMPLETED:
04:00 PM
NARRATIVE
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Licensing Program Analyst (LPA) Melchisedeck Augustin made an unannounced visit to attend a “Back to School” meeting, which consisted of parents, facility staff and law enforcement personnel. The purpose of the meeting was for the center to share information with parents and to discuss an incident that occurred on 09/04/19, where a neighbor exhibited threaten behavior. Parents and other members were allowed the opportunity to ask questions, which were addressed by facility staff and law enforcement personnel. The facility discussed the protocol for staff to follow in case an emergency, staff training requirements, reporting requirements, methods to enhance security and ways to ensure the safety of children and staff. The facility acknowledges and agrees to notify parents about all unusual incidents in a timely manner and the facility will continue to implement the plan discussed at the meeting. Law Enforcement personnel provided parents and staff with their business card and encouraged all members at the meeting to contact law enforcement and to develop a rapport with law enforcement.

This report was reviewed and discussed with the Director. Notice of Site Visit shall be posted for 30 days from today’s inspection. There were no Title 22 deficiencies cited during today’s inspection.
SUPERVISOR'S NAME: Leslie LeporiTELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Melchisedeck AugustinTELEPHONE: (707) 494-4918
LICENSING EVALUATOR SIGNATURE:

DATE: 09/11/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2019
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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