434400029-6-25-2025-07-CC-LFII-DHYNRJ-20250625104136

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434400029
Report Date: 06/25/2025
Date Signed: 06/25/2025 10:41:49 AM

Document Has Been Signed on 06/25/2025 10:41 AM - 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:	CHRISTOPHER RANCH HEAD START		FACILITY NUMBER:	434400029
ADMINISTRATOR/ DIRECTOR:	ANGELICA GUZMAN		FACILITY TYPE:	850
ADDRESS:	305 BLOOMFIELD AVENUE		TELEPHONE:	(408) 453-6900
CITY:	GILROY	STATE: CA	ZIP CODE:	95020
CAPACITY: 48	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	06/25/2025
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:00 AM
MET WITH:	Dora Bernardo		TIME VISIT/ INSPECTION COMPLETED:	10:50 AM

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	Licensing Program Analyst (LPA), Liridon Fici (Doni), conducted a Case Management inspection on an incident that occurred on 6/10/2025 and was greeted by Dora Bernardo, Family Advocate (FA) and informed her the reason for the visit. Rocio Litle, Director was not able to be present at the center and gave Dora Bernardo, FA consent to review and sign the report on the directors behalf. During the visit, LPA conducted a phone interview with Rocio Litle, Director regarding an incident on 6/10/2025. The director stated there was an internal investigation that was conducted 6/10/2025 with the center and ended the same day. Staff were interviewed and all staff stated they did not witness or hear anything about the incident. Director stated this was reported at home because Child 1 (C1)’s parents informed the director about the incident. The director informed LPA she is not aware which staff it might be because C1 did not provide enough information about the incident. Director stated when C1’s parents asked their child questions about the incident, the child did not provide any information on who and when it occurred. The incident was reported to CCL, and the Gilroy Police Department. Director mentioned that an office from the Gilroy Police Department interviewed C1 and asked the child two (2) questions, “ how old are you, and what is your favorite color”, and the child replied, “1 year old”, and “ the color Blue”. C1’s parents had no concerns about the incident and continued their child’s care at the school. Araceli Fonseca, Program Manager (PM) arrived the next day 6/11/2025, to conduct her own internal investigation and interviewed all staff at the center and ended the investigation the same day. Director informed LPA that the PM did not have enough information about this incident and closed the investigation. LPA reviewed C1’s Health Screening and Medical Assessment. No citations were issued at today's visit. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted with FA, and a copy of this report was reviewed and provided along appeal rights.

NAME OF LICENSING PROGRAM MANAGER: Gladys Kuizon
NAME OF LICENSING PROGRAM ANALYST: Liridon Fici
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 06/25/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/25/2025

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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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)

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