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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 274408752
Report Date: 11/30/2023
Date Signed: 11/30/2023 04:10:22 PM

Document Has Been Signed on 11/30/2023 04:10 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:KIDS AT PLAYFACILITY NUMBER:
274408752
ADMINISTRATOR:DENISE CARATTINIFACILITY TYPE:
850
ADDRESS:1441 CONSTITUTION BLVD. # 151TELEPHONE:
(831) 769-8697
CITY:SALINASSTATE: CAZIP CODE:
93906
CAPACITY: 52TOTAL ENROLLED CHILDREN: 52CENSUS: 19DATE:
11/30/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
01:55 PM
MET WITH:Indya HawthoneTIME COMPLETED:
04:10 PM
NARRATIVE
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Licensing Program Analyst (LPA), Elizabeth Larios, met with Designated Teacher (Facility Representative), Indya Hawthone, for an unannounced Case Management visit. LPA explained the nature of today's visit. Licensee Denise Carattini was not at the facility due to a family emergency.

The purpose of the inspection is to re-cite for deficiencies given on a annual required inspection on 10/24/2023. Plan of corrections have not been submitted to the department that were due 10/25/2023 & 11/07/2023.

LPA re-cited Type A and Type B citations. Exit interview conducted with Teacher, Indya Hawthone, and a copy of this report was provided.

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

SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Elizabeth Larios
LICENSING EVALUATOR SIGNATURE: DATE: 11/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/30/2023
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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Document Has Been Signed on 11/30/2023 04:10 PM - It Cannot Be Edited


Created By: Elizabeth Larios On 11/30/2023 at 02:55 PM
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: KIDS AT PLAY
FACILITY NUMBER: 274408752

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/30/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
12/01/2023
Section Cited
CCR
101216.3(g)

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(a) There shall be a ratio of one teacher visually observing and supervising no more than 12 children in attendance, except as specified in (b) and (c) below.

This requirement is not met as evidenced by:
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Director will submit Plan of Correction to LPA by 12/01/2023 stating how the facility will remain in ratio at all times.
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Based on observation and interview, the licensee did not comply with the section cited above which poses an immediate health, safety or personal rights risk to persons in care. Upon arrival, LPA Farida observed one teacher with 13 preschool children on 10/24/2023. Teacher/Facility Representative stated that one teacher was on break.
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Type B
12/01/2023
Section Cited
HSC1597.16(a)(1)

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(1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test.

This requirement is not met as evidenced by:
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Director will complete the Water Lead Testing and submit proof of completion to LPA by Plan of Correction date of 12/01/2023.
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Based on observation and interview, the licensee did not comply with the section cited above which poses a potential health, safety or personal rights risk to persons in care. Facility Representative stated that Water Lead Testing was not completed for this facility during inspection on 10/24/2023.
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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:Joel Segura
LICENSING EVALUATOR NAME:Elizabeth Larios
LICENSING EVALUATOR SIGNATURE:
DATE: 11/30/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/30/2023


LIC809 (FAS) - (06/04)
Page: 2 of 3
Document Has Been Signed on 11/30/2023 04:10 PM - It Cannot Be Edited


Created By: Elizabeth Larios On 11/30/2023 at 03:08 PM
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: KIDS AT PLAY
FACILITY NUMBER: 274408752

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/30/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/01/2023
Section Cited
HSC
1596.7995(a)(1)

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(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

This requirement is not met as evidenced by:
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Director will submit proof of completed immunizations for staff S2 and S3 by plan of correction date of 12/01/2023.

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Based on record review and interview from LPA Farida on 10/24/2023 the licensee did not comply with the section cited above which poses a potential health, safety or personal rights risk to persons in care. LPA Farida did not observe immunization records for MMR, Tdap and Influenza for staff S2 and S3.
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Type B
12/01/2023
Section Cited
HSC1596.8662(b)(1)

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(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:
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Director will submit proof of completed Mandated Reporter Training for Staff S3 to LPA by 12/01/2023.

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Based on record review and interview from LPA Farida on 10/24/2023, the licensee did not comply with the section cited above for one staff which poses a potential health, safety or personal rights risk to persons in care.
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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:Joel Segura
LICENSING EVALUATOR NAME:Elizabeth Larios
LICENSING EVALUATOR SIGNATURE:
DATE: 11/30/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/30/2023


LIC809 (FAS) - (06/04)
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