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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 440710482
Report Date: 12/18/2024
Date Signed: 12/18/2024 01:14:36 PM

Document Has Been Signed on 12/18/2024 01:14 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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:ENCOMPASS HEAD STARTFACILITY NUMBER:
440710482
ADMINISTRATOR/
DIRECTOR:		ANA TORRESFACILITY TYPE:
850
ADDRESS:255 SWIFT STREETTELEPHONE:
(831) 724-3885
CITY:SANTA CRUZSTATE: CAZIP CODE:
95060
CAPACITY: 28TOTAL ENROLLED CHILDREN: 28CENSUS: 14DATE:
12/18/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Estela RodriguezTIME VISIT/
INSPECTION COMPLETED:
01:30 PM
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On December 18, 2024 at 9:30 AM., Licensing Program Analyst (LPA) Elimika Woods conducted an unannounced Annual Random Inspection and met with the facility representative Estela Rodriguez. LPA disclosed the purpose of the inspection and was granted entry into the facility by the facility representative. There were 14 preschool age children present during this inspection and four (4) additional staff members. The facility was toured inside and out for a health and safety inspection. The hours of operation are 8:15 AM- 2:15 PM, Monday -Friday

LPA checked the facility RECORDS and they show all individuals subject to criminal record review have a clearance or exemption and have been associated to the facility. LPA conducted a census of the children and the census matches the 14 electronic signatures signed in on the electronic system. LPA reviewed four (4) children's files and four (4) staff files around 11:30 AM. All staff files have required Health Screening, and Employee Rights forms, and all children files contains Personal Rights, Medical Consent forms, and Identification & Emergency Information. At least one opening/ closing staff member has a current CPR & First Aid Certificate.

The one classroom was inspected around 10:00 AM and teacher child ratio was observed. There are adequate play and learning materials available. The floors are well maintained and the furniture is the correct size for preschool age children. The classrooms equipment is in good repair and the room temperature is adequate for children in care. There is proper individual storage space for each child and the cubbies have their names and pictures posted on the shelves. The isolation area for sick children is the sick mat, away from other children in care.

LPA tested the centers smoke & carbon monoxide detectors and found them to be functioning properly. The center has a working telephone, pull down fire alarm system, and multiple fully charged 2A10BC fire extinguishers throughout the center, which meets standards established by the State Fire Marshal. Disaster drills are being conducted at least once every 6 months and the last one conducted was on 12/03/2024. All required documents are posted in a public accessible area.

See 809-C.
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Elimika Woods
LICENSING EVALUATOR SIGNATURE: DATE: 12/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/18/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: ENCOMPASS HEAD START
FACILITY NUMBER: 440710482
VISIT DATE: 12/18/2024
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This facility provides breakfast, lunch, and snacks for the children in care. There are weekly menus posted at the facility. LPA observed an area where they have a refrigerator this area is clean and free of evidence of rodents. Food is protected from contamination and, per staff, contaminated food is discarded immediately. LPA reminded the facility representative that all persons engaged in food preparation and service shall observe personal hygiene and food service sanitation practices to protect food from contamination. All storage containers for solid waste have tight fitting covers that are in good repair.

LPA’s observations during the visit

At 9:55 AM, the teachers were outside on the playground watching the children run and play. One child approach me on the yard and ask me my name as she introduce herself to me. She wanted to see if I could do the Hula Hoop and handed the toy. After trying to Hula Hoop the child laughed at me and preceded to show me how it was done. After that encounter I observed another staff member in the garden area with children looking at the flowers in the planter box and having discussion about the flowers. I also saw two boys sitting at a table building stuff with the building blocks.

The outdoor area has a garden with planter boxes, a canopy for shade, a sand box, and a small play house. There are no play structures that are required to be anchored to the ground and the yard is fully fenced and free of defects or dangerous conditions. The play equipment is age appropriate and in good repair. The staff brings to children's water bottles and cups to the playground to keep them hydrated during outside play.

LPA checked the staff bathroom around 10:15 AM, and was told by the representative it was separate from the children’s bathroom. The children's bathroom is located inside the classroom. LPA checked and flushed all of the toilets in each bathroom to see if they were working and ran the water in the faucets to make sure the temperature did not get too hot for children in care. LPA verify the all the sinks, toilets, and faucets were working in a safe and sanitary operating condition during todays inspection.



The following deficiencies were observed during today's inspection: CCC
· At 11:00 AM, LPA observed during record review that the facility had a Lead Exceedance.

LPA discussed with the Facility Representative PIN 21-21-CCP-Release of the Written Directives for Lead Testing of Water in Licensed Child Care Centers Per AB 2370. Http://cdss.ca.gov/Portals/9/CCLD/PIN-21-21-CCP.pdf

See 809-C
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Elimika Woods
LICENSING EVALUATOR SIGNATURE:

DATE: 12/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2024
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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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: ENCOMPASS HEAD START
FACILITY NUMBER: 440710482
VISIT DATE: 12/18/2024
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California Law requires Child Care Centers licensees to report unusual incidents or injuries to children in care to child's parents and to the Department of Social Services using the Unusual Incident/Injury form (LIC 624). Incidents must be reported within 24 hours by phone, fax, or electronic mail. The facility representative was also reminded that Mandated Reporter Training ("General" and "Child Care Providers") is required for all staff and is to be renewed every 2 years by visiting www.mandatedreporterca.com.

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 PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication. Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-carecenters/.



LPA reminded the facility representative that a refrigerator shall be used to store any medications that requires refrigeration. The center is equipped with fully stocked first aid kits that is available in the classroom.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

The facility representative was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

The facility representative was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

See 809-D for deficiencies cited today. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the facility representative Estela Rodriguez.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Elimika Woods
LICENSING EVALUATOR SIGNATURE:

DATE: 12/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2024
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Document Has Been Signed on 12/18/2024 01:14 PM - It Cannot Be Edited


Created By: Elimika Woods On 12/18/2024 at 12:50 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: 440710482

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/18/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
WD
101700(b)
Written Directives for Lead Testing
(b) All licensed Child Care Centers operating in buildings constructed before January 1, 2010, shall test their water for lead pursuant to these written directives.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in which the Water Lead Exceedance had a Lead Action Level of more than 5.5 ppb, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/20/2025
Plan of Correction
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The facility representative will submit new testing results or repair and replace existing faucets to LPA Woods via fax, text, or email.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Chandra Charles
LICENSING EVALUATOR NAME:Elimika Woods
LICENSING EVALUATOR SIGNATURE:
DATE: 12/18/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/18/2024


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