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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 270703733
Report Date: 02/23/2023
Date Signed: 02/23/2023 01:27:59 PM

Document Has Been Signed on 02/23/2023 01:27 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
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:MONTEREY PENINSULA COLLEGE CHILDREN'S CENTERFACILITY NUMBER:
270703733
ADMINISTRATOR:JEFFERY PROCIVEFACILITY TYPE:
850
ADDRESS:980 FREMONT STREETTELEPHONE:
(831) 646-4066
CITY:MONTEREYSTATE: CAZIP CODE:
93940
CAPACITY: 96TOTAL ENROLLED CHILDREN: 67CENSUS: 52DATE:
02/23/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
12:02 PM
MET WITH:Jeff ProciveTIME COMPLETED:
01:40 PM
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Licensing Program Analyst (LPA), Joe Macias, conducted an unannounced case management inspection in response to an unusual incident that the facility self reported to Community Care Licensing (CCL) on January 27, 2023. LPA met with Program Director Jeff Procive, and explained the nature of today's inspection to him. There were a total of 52 preschool age children at the facility today along with 11 fully qualified teachers, and 5 student workers as this is a lab school.

This case management inspection was made to inquire about an unusual incident that occurred on January 25, 2023.

During today's visit LPA Macias toured the facility, interviewed staff, reviewed the LIC 624, and obtained copies of pertinent information. Based on staff interview, as well as the self reported incident report; a child was injured while outside on the playground. The child was on the monkey bars and lost balance. The child fell and obtained an injury to the right arm. Procive observed the entire incident, rendered first aid, and immediately called the child's parents.

LPA Macias reviewed the importance of maintaining constant supervision. The facility shall provide care and supervision as necessary to meet the children's needs. No child shall be left without the supervision of a teacher at any time. Supervision shall include visual observation.

As a result of the incident the college is currently evaluating the play structure and the effectiveness of the resilient material. Upon completion of the evaluation, the Director will submit the findings to CCL.

No deficiencies cited, exit interview conducted, and a copy of this report was reviewed by the Director Jeff Procive.

A NOTICE OF SITE VISIT WAS ISSUED, POSTED NEAR THE FRONT ENTRANCE TO THE CENTER, AND MUST REMAIN POSTED FOR 30 CONSECUTIVE DAYS.

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Joseph Macias
LICENSING EVALUATOR SIGNATURE: DATE: 02/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/23/2023
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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