<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 274400122
Report Date: 10/06/2025
Date Signed: 10/06/2025 12:31:33 PM

Document Has Been Signed on 10/06/2025 12:31 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 CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:SAN JERARDO MIGRANT HEAD STARTFACILITY NUMBER:
274400122
ADMINISTRATOR/
DIRECTOR:		GARCIA, MARIA C.FACILITY TYPE:
850
ADDRESS:24495 CALLE EL ROSARIOTELEPHONE:
(831) 751-9376
CITY:SALINASSTATE: CAZIP CODE:
93908
CAPACITY: 60TOTAL ENROLLED CHILDREN: 60CENSUS: 13DATE:
10/06/2025
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:10 AM
MET WITH:Carmen AlvarezTIME VISIT/
INSPECTION COMPLETED:
12:50 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
On October 6, 2025, at 9:10am, Licensing Program Analyst (LPA) Darnella Barnes conducted an unannounced case management inspection. The inspection was initiated in response to a self-reported incident that occurred on October 2, 2025, at approximately 6:20am. Upon arrival, LPA Barnes met with Site Supervisor Carmen Alvarez. The purpose of the visit—to assess the facility's compliance with Title 22 regulations—was explained. Alvarez granted full access to the facility

A tour of the inside and outside facility was conducted. Present was Site Supervisor Carmen Alvarez, Family Services Advocate Juliana Garcia, nine (9) teachers, and thirteen (13) children. Staff appeared engaged and provided proper supervision.

The incident involved Child #1 (C1) being left unattended on a school bus.

Site Supervisor Alvarez stated C1 was left alone on the bus for approximately 7-8 minutes. Site Supervisor reported the bus driver (S1) had left the bus to use the restroom, returned to the bus to prepare for the second route, and was unaware C1 remained seated in the back. Staff (S2) Bus Monitor/Teacher Aide had escorted two children to Preschool Room 1 and was dropping off three others at Preschool Room 2 when P1, who was dropping off her child at Preschool 2 classroom, and stated she saw a child on the bus, noting the child’s ponytail was tall enough to be visible above the seat. S2 immediately returned to the bus, retrieved C1, and brought child to Room 2.

-----Continued on Next Page ----.

.


NAME OF LICENSING PROGRAM MANAGER: Gladys Kuizon
NAME OF LICENSING PROGRAM ANALYST: Darnella Barnes
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 10/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/06/2025
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 4
California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
Page: 2 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: SAN JERARDO MIGRANT HEAD START
FACILITY NUMBER: 274400122
VISIT DATE: 10/06/2025
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
26
27
28
29
30
31
32
The facility immediately contacted C1’s parent, conducted a health check on the child (the child was not harmed) , and reported the incident to Community Care Licensing. Both staff members (S1) and (S2) involved were relieved of duty pending further review. Bus services were discontinued, with no plans to resume until a new driver and aide are trained.

LPA reviewed facility documentation, including children’s and parents’ rosters, transportation policy, bus attendance log for 10/02/2025, active supervision policy, bus driver and aide duties, and internal procedures for unloading and headcounts. LPA also discussed transportation policies with Site Supervisor Alvarez and Family Services Advocate Juliana Garcia. The facility confirmed an internal review was underway and corrective measures were being implemented

No injuries were reported. Investigation ongoing.

LPA Barnes conducted interviews, reviewed records, observed and found that there was a violation of Title 22. Responsibility for Providing Care and Supervision - (a) The licensee shall provide care and supervision as necessary to meet the children's needs. (1) No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation, and therefore a Citation A with an immediate Civil Penalty of $500 was assessed, as documented on the attached LIC809D and LIC421M

LPA Darnella Barnes informed facility Site Supervisor Carmen Alvarez that this report dated 10/6/25 documents with one Type A citation which shall be posted for 30 consecutive days as there is an immediate risk to the health, safety, or personal rights of children in care.

Also, LPA Darnella Barnes informed the facility Site Supervisor Carmen Alvarez to provide a copy of this licensing report dated (10/6/25) that documents one Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

A notice of site visit was given and must remain posted for 30 days. Appeals rights provided.


Exit interview conducted and report was reviewed with the Site Supervisor Carmen Alverez

-----END OF REPORT -----
NAME OF LICENSING PROGRAM MANAGER: Gladys Kuizon
NAME OF LICENSING PROGRAM ANALYST: Darnella Barnes
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/06/2025
LIC809 (FAS) - (06/04)
Page: 3 of 4
Document Has Been Signed on 10/06/2025 12:31 PM - It Cannot Be Edited


Created By: Darnella Barnes On 10/06/2025 at 11:46 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: SAN JERARDO MIGRANT HEAD START
FACILITY NUMBER: 274400122

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/06/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/06/2025
Section Cited
CCR
101229(a)(1)

1
2
3
4
5
6
7
Responsibility for Providing Care and Supervision - (a)The licensee shall provide care and supervision as necessary to meet the children's needs. (1) No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation. This requirement was not met as evidenced by:
1
2
3
4
5
6
7
The Site Supervisor shall develop and implement a written Plan of Correction addressing the incident in which a child was left on the school bus. This plan must outline immediate and long-term steps to prevent recurrence, including but not limited to: mandatory bus sweeps, dual sign-in/sign-out verification, staff retraining, and compliance monitoring procedures. The Site Supervisor shall ensure that all corrective measures are in place and that all transportation and
8
9
10
11
12
13
14
Based on interviews and the Site Director's own admission, it was determined that Child C1 was left unsupervised on the bus. This incident presents an immediate risk to the health, safety, and personal rights of children in care
8
9
10
11
12
13
14
classroom staff are trained accordingly. Documentation of staff training, updated procedures, and verification logs must be submitted to LPA by 10/8/25. The Site Supervisor is responsible for ongoing monitoring and enforcement of the corrective actions as outlined.

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Gladys Kuizon
NAME OF LICENSING PROGRAM MANAGER:
Darnella Barnes
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 10/06/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/06/2025


LIC809 (FAS) - (06/04)
Page: 4 of 4