440710081-5-1-2023-07-CC-CNEN-CREU44-20230501151430

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 440710081
Report Date: 05/01/2023
Date Signed: 05/01/2023 03:14:38 PM

Document Has Been Signed on 05/01/2023 03:14 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:	ENCOMPASS HEAD START		FACILITY NUMBER:	440710081
ADMINISTRATOR:	DIANNA LEON		FACILITY TYPE:	850
ADDRESS:	441 ROGERS AVENUE		TELEPHONE:	(831) 713-7373
CITY:	WATSONVILLE	STATE: CA	ZIP CODE:	95076
CAPACITY: 42	TOTAL ENROLLED CHILDREN: 20	CENSUS: 16	DATE:	05/01/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:17 PM
MET WITH:	Lorena Gonzalez & Estela Rodriguez		TIME COMPLETED:	03:24 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	Licensing Program Analyst (LPA), Cortney Nelson, met with Education Manager, Lorena Gonzalez, and Site Supervisor, Estela Rodriguez, for an unannounced Required- 1 Year Inspection. LPA was granted access to the facility by the Teacher-Director, Dalia Flores, and toured both indoors and outdoors during the inspection. The facility is located at All Saints Episcopal Church and is currently only utilizing Classroom #2 due to low enrollment/staffing. (License is for Classroom #1 & #2.) Upon arrival, there were sixteen (16) children and three (3) staff members, which is compliant with the facility license capacity and ratio requirements. LPA observed all required postings near the entrance to the facility and the hours of operation are Monday – Friday, 8:00AM-4:30PM (children are in care from 8:15AM-2:15PM). LPA reviewed sign-in/out, facility roster (LIC9040), and fire drill log and observed last fire drill was conducted 4/19/2023, which is compliant with the six-month requirement. LPA observed three fully charged 3A40BC fire extinguishers (last serviced: 8/2022), functioning smoke detector and carbon monoxide detector. The facility provides Incidental Medical Services and LPA observed that the medication is properly stored out of reach of children, with the proper documentation. There are no weapons or firearms on the premises. This facility provides Incidental Medical Services- IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual- Regulation Interpretations and Procedures for Child Care Centers, Section 101173 and 101226. The following information regarding ADA was provided: US Department of Justice toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Cortney Nelson
LICENSING EVALUATOR SIGNATURE:	DATE: 05/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2023

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 3

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: ENCOMPASS HEAD START	FACILITY NUMBER: 440710081
	VISIT DATE: 05/01/2023

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

Indoor areas were inspected by the LPA today and observed to be clean, orderly, and safe for the day care children. During today's inspection, LPA observed children napping and eating snack. There are sufficient age-appropriate materials, toys, and play equipment in the facility. There is a properly barricaded wall heater located in the classroom. Drinking water is readily available for children via water dispensers and disposable cups. Staff and children’s bathrooms are clean, sanitary, and operable. There is a separate staff bathroom, not utilized by the children, which an isolated child can use if necessary. There is a working telephone. Water lead testing was completed for the facility by M3 Environmental, LLC between January 4-5 2022 and no Action Level Exceedances were found. Water lead testing results were provided to LPA by Lorena and she states that the required licensing documents will be submitted.

The outdoor area of the facility was inspected and observed to be fenced in. There are a playground, garden, tables for activities, and bikes for the children to use. LPA observed play equipment was in good condition, age-appropriate, and has sufficient resilient materials (sand) to absorb falls. No outdoor bodies of water were observed during today’s inspection. Shaded rest area is provided by canopy and building overhang.

The facility provides food through Revolution Food and breakfast, lunch, and PM snack is served to the children. The menu is in writing and posted at least one week in advance, accessible to authorized representatives. The kitchen and storage area is clean and free of litter and rubbish.

Five (5) children’s files and three (3) staff files were reviewed and all required documents were present. All staff members have current CPR/First-Aid, Teacher-Directors expires 4/11/2024, and Mandated Reporter Training that expires on 1/24/2024. LPA reminded both trainings must be renewed every 2 years.

Exit interview conducted and report was reviewed with Education Manager, Lorena Gonzalez, and Site Supervisor, Estela Rodriguez.

As a result of today’s inspection, a deficiencies was cited, see 809-D.

A NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 DAYS.

SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Cortney Nelson
LICENSING EVALUATOR SIGNATURE:	DATE: 05/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2023

LIC809 (FAS) - (06/04)

Page: 2 of 3

Document Has Been Signed on 05/01/2023 03:14 PM - It Cannot Be Edited

Created By: Cortney Nelson On 05/01/2023 at 02:57 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: ENCOMPASS HEAD START	FACILITY NUMBER: 440710081
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/01/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101212(b)

Reporting Requirements

(b) The name of the child care center director, and any fully qualified teacher(s) designated to act in the child care center director's absence, shall be reported to the Department within 10 days of a change of child care center director or designee(s). This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, interview, and record review, the licensee did not comply with the section cited above as the facility currently has a different Teacher-Director which was not reported to the Department, which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 05/05/2023
	Plan of Correction
1 2 3 4	The Licensee will submit Site Director Qualifications for review to the Department by 5/5/2023. LPA advised completion of Operations/Recordkeeping Orientation.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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:

Cortney Nelson

LICENSING EVALUATOR SIGNATURE:

DATE: 05/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2023

LIC809 (FAS) - (06/04)

Page: 3 of 3