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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701546
Report Date: 11/22/2024
Date Signed: 11/22/2024 03:00:15 PM

Document Has Been Signed on 11/22/2024 03:00 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: 30CENSUS: 11DATE:
11/22/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:00 PM
MET WITH:Director Jessica BautistaTIME VISIT/
INSPECTION COMPLETED:
03:00 PM
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On 11/22/24 at 2:00PM, Licensing Program Analyst (LPA) Luigi Gargaro conducted a follow up case management visit with facility director Jessica Bautista regarding a self-reported 10/15/24 incident in which child #1 (C1) ran from the facility play yard without it being immediately noticed by facility staff on to nearby church grounds.

During the course of the incident investigation, analyst conducted interviews with the facility director and the staff members involved in the incident as well as an involved church member. Analyst also reviewed related documentation regarding the incident. Analyst also inspected the facility play yard and church areas that were involved in the incident. C1 is still attending the facility.

Based on information gathered, analyst determined that on day of incident staff members #1, #2, #3 and #4 (S1, S2, S3 and S4) were in the facility play yard supervising nine children. At the time of the incident, C1 was on one side of the yard while the staffers were engaged in putting away toys and supervising the other day care children.

The incident appeared to have occurred when an administrative staff member of the co-located church opened a facility exit gate leading to church grounds to bring in trash from the driveway. At that point, C1 went underneath a latched rolling screen gate without being immediately seen by the yard supervising teachers. The child was only noticed as having left the play yard when the church staff member called out to the teachers as the incident was occurring. C1 was able to go out the open facility exit gate on to the church property and almost to the street exit gate but was pursued by the church staff member who maintained child in his sights until S1 immediately followed and got to the child who had stopped in the church driveway and brought her back.

Though the child initially was able to go under the rolling screen gate to get to the exit door due to a lapse of supervision by staff members as they were cleaning up, in the obtained testimony it was consistently characterized that C1 was immediately pursued after getting under the mesh rolling gate and though got through the open exit gate, remained on church property and never got to the always locked street exit gate. before being brought back by S1. It was also determined that visual supervision was maintained on the child at the point after she went under the rolling gate and maintained by the church member and staffer thereafter. The child appeared to have suffered no injury or trauma from the incident.
SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Luigi Gargaro
LICENSING EVALUATOR SIGNATURE: DATE: 11/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/22/2024
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
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 START
FACILITY NUMBER: 376701546
VISIT DATE: 11/22/2024
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A Type "A" violation was cited for a lapse of supervision for the incident (see related 809D citation page). Appeal Rights (1/16) were discussed. Upon receipt of a type A violation, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. Today’s report was reviewed with and signed for by facility director, 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 analyst left the facility.
SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Luigi Gargaro
LICENSING EVALUATOR SIGNATURE:

DATE: 11/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/22/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 11/22/2024 03:00 PM - It Cannot Be Edited


Created By: Luigi Gargaro On 11/22/2024 at 02:24 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
, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: ECS - ST. MATTHEW'S HEAD START

FACILITY NUMBER: 376701546

DEFICIENCY INFORMATION FOR THIS PAGE:

VISIT DATE: 11/22/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/22/2024
Section Cited
CCR
101229(a)(1)

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Responsibility for Providing Care and Supervision (a)(1) The licensee shall provide care and supervision ...No child(ren) shall be left without the supervision of a teacher at any time...

The requirement was not met as evidenced by:
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Facility director states she will submit a written plan of correction detailing what steps have and will be implemented to prevent the situation from potentially recurring at the facility. Plan will be submitted to analyst for review by 11/25/24.
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Based on interviews and record reviews, staff had a lapse in supervision of Child #1 (C1) during a 10/15/24 self-reported incident at the facility, which posed an immediate Health and Safety risk to the child 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:Jason Garay
LICENSING EVALUATOR NAME:Luigi Gargaro
LICENSING EVALUATOR SIGNATURE:
DATE: 11/22/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/22/2024


LIC809 (FAS) - (06/04)
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