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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 440710612
Report Date: 12/08/2022
Date Signed: 12/08/2022 03:29:24 PM

Document Has Been Signed on 12/08/2022 03:29 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:STARLIGHT PRESCHOOL CENTERFACILITY NUMBER:
440710612
ADMINISTRATOR:CONCEPCION MORALESFACILITY TYPE:
850
ADDRESS:235 HAMMER DRIVETELEPHONE:
(831) 724-3885
CITY:WATSONVILLESTATE: CAZIP CODE:
95076
CAPACITY: 40TOTAL ENROLLED CHILDREN: 40CENSUS: DATE:
12/08/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:35 PM
MET WITH:Lorena Gonzalez & Cecilia EsquivelTIME COMPLETED:
03:45 PM
NARRATIVE
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Licensing Program Analyst (LPA), Cortney Nelson, met with Education Manager, Lorena Gonzalez, and Site Supervisor, Cecilia Esquivel, and explained purpose of today's visit- to follow-up on incident that occurred on 10/14/2022 and conduct staff interviews.

On 10/14/2022, the facility sent a child home with a soiled diaper. The child's diaper was described as being very wet and a cause for concern by the child's parent. The facility self admit that the child was not changed due to an over-sight by staff present that day.

A diaper changing schedule has since been created and posted to ensure that a similar situation does not occur again in the future. The chart clearly indicates which child needs to be changed, the teacher who will be in charge of changing, and the number of times the child has been changed during the day. Lead Teacher, Edgar, designed the new diaper changing schedule and Site Supervisor, Cecilia, has checked in/monitored the facility closer since the incident occurred.

Exit interview conducted with Education Manager, Lorena Gonzalez, and Site Supervisor, Cecilia Esquivel.

As a result of today's inspection, a deficiency was cited, see LIC809-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: 12/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/08/2022
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 2
Document Has Been Signed on 12/08/2022 03:29 PM - It Cannot Be Edited


Created By: Cortney Nelson On 12/08/2022 at 01:08 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: STARLIGHT PRESCHOOL CENTER
FACILITY NUMBER: 440710612

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/08/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/09/2022
Section Cited
CCR
101223(a)(2)

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101223 Personal Rights (a) The Licensee shall ensure that each child is accorded the following personal rights. (2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs.

This requirement was not met as evidenced by:
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The facility has already made a plan of correction and has updated the diaper changing chart to include the names of the children who need diaper changes, teacher responsible for changing, and the number of times the child has been changed.
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The Licensee did not provide safe and healthful accommodations for a child who was sent home with a soaked diaper, which poses a potential risk to the health, safety, and personal rights of children in care.
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Plan of correction has already been completed for the facility and diaper changing chart is now being utilized. Deficiency has been cleared.

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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:Joel Segura
LICENSING EVALUATOR NAME:Cortney Nelson
LICENSING EVALUATOR SIGNATURE:
DATE: 12/08/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/08/2022


LIC809 (FAS) - (06/04)
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