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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701546
Report Date: 11/06/2024
Date Signed: 11/06/2024 01:50:37 PM

Document Has Been Signed on 11/06/2024 01:50 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, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME:ECS - ST. MATTHEW'S HEAD STARTFACILITY NUMBER:
376701546
ADMINISTRATOR/
DIRECTOR:
PATRICIA JAIMEZFACILITY TYPE:
850
ADDRESS:521 EAST 8TH STTELEPHONE:
(619) 512-9886
CITY:NATIONAL CITYSTATE: CAZIP CODE:
91950
CAPACITY: 30TOTAL ENROLLED CHILDREN: 19CENSUS: 15DATE:
11/06/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Site Supervisor Jessica BautistaTIME VISIT/
INSPECTION COMPLETED:
01:55 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 11/06/24 at 10:00AM, Licensing Program Analysts (LPAs) Luigi Gargaro and Oscar Picazo conducted a follow up case management visit with site supervisor Jessica Bautista regarding a self-reported 10/15/24 incident in which child #1 (C1) exited the facility play yard and went on to the nearby church grounds.

During the course of the incident investigation, analysts conducted interviews with the site supervisor and the staff members involved in the incident and reviewed report documentation. Analysts also inspected the facility play yard and church areas that were involved in the incident. Analysts were unable to interview a church employee who witnessed and was peripherally involved in the incident today. C1 is still attending the facility.

No violations were cited during today's visit. Today’s report was reviewed with and signed for by site supervisor, Jessica Bautista. A copy of the report, appeal rights and the notice of site visit, that is to be posted for 30 days, was provided to Ms. Bautista before analysts left the facility.
SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Luigi Gargaro
LICENSING EVALUATOR SIGNATURE: DATE: 11/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/06/2024
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 1