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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 444400083
Report Date: 12/15/2022
Date Signed: 12/15/2022 11:47:28 AM

Document Has Been Signed on 12/15/2022 11:47 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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:TERRY JIMENEZ CHILDREN'S CENTERFACILITY NUMBER:
444400083
ADMINISTRATOR:L GONZALEZ/E MARINFACILITY TYPE:
850
ADDRESS:201 BREWINGTON AVENUETELEPHONE:
(831) 763-6903
CITY:WATSONVILLESTATE: CAZIP CODE:
95076
CAPACITY: 34TOTAL ENROLLED CHILDREN: 34CENSUS: DATE:
12/15/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:09 AM
MET WITH:Cecilia Esquivel & Ana AguadoTIME COMPLETED:
11:57 AM
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Licensing Program Analyst (LPA), Cortney Nelson, met with Site Supervisor, Cecilia Esquivel, and Family Services Manager, Ana Aguado, for an unannounced Required- 1 Year Inspection. The facility is located on the campus of E. A. Middle School near the track and is currently gated off to the public, a phone call must be made to enter the facility. The LPA was granted access to the facility by staff member, Grecia, and toured both indoors and outdoors during the inspection. Upon arrival, there were 15 preschool-age children and 3 staff members present, which is compliant with the facility license capacity and Title 5 ratio requirements. LPA observed all required postings near the entrance to the facility and the hours of operation are Monday – Friday, 8:00AM-5:00PM.

LPA reviewed sign-in/out sheets, facility roster (LIC9040), and fire/disaster drill log during today’s inspection. The facility has an active waiver for electronic sign-in/out and it was observed to be completed with full legal signature and time of day. The last fire/disaster drill was conducted on 12/4/2022, which is compliant with the six-month requirement for facilities. LPA observed two fully charged 3A40BC fire extinguishers and functioning carbon monoxide detector. The facility has a built in fire detection system. There is a child in care who require Incidental Medical Services and LPA observed that the inhaler is properly stored out of reach of children with the proper documentation (IMS). The Site Supervisor states that 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: 12/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/15/2022
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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: TERRY JIMENEZ CHILDREN'S CENTER
FACILITY NUMBER: 444400083
VISIT DATE: 12/15/2022
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Indoor areas of the facility were inspected by the LPA today and observed to be clean, orderly, and safe for the day care children. Classroom #2 at the facility for the toddler component is currently closed and being utilized as a storage area. Classroom #1 was observed by the LPA today and children were engaged in cutting with scissors and morning circle time with teacher Eduardo. There are sufficient age-appropriate materials, toys, and play equipment in the facility. The floors are clean and free of tripping hazards. Drinking water is readily available for children in the facility 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 in the facility.

The outdoor area of the facility was inspected and observed to be fenced in. There is a play structure, maintained sandbox, and small wooden play house for the children to engage with during outside play. 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 building overhang, large trees, and umbrellas.

Food is provided through Revolutions food program and is stored, prepared, and served by the facility in a safe and healthful manner to the children. Children participate in a full day program and are provided breakfast, lunch, and PM snack. 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) preschool-age children’s files were reviewed during today’s inspection and all required documents were present including Acknowledgment of Receipt of Licensing Report (LIC9224).

Four (4) staff files were reviewed and all required documents were present. The teacher-director has current CPR/First-Aid that expires 5/9/2024 and current Mandated Reporter Training that expires on 1/13/2024. LPA advised that Mandated Reporter training must be completed for Child Care Providers per AB1207, not general training, and must be renewed by all staff every 2 years.
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Cortney Nelson
LICENSING EVALUATOR SIGNATURE:

DATE: 12/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2022
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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: TERRY JIMENEZ CHILDREN'S CENTER
FACILITY NUMBER: 444400083
VISIT DATE: 12/15/2022
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The Site Supervisor understands that the teacher- director shall be on the premises during the hours the center is in operation and that children at the center shall be visually supervised at all times. LPA reminded the Site Supervisor that there shall be at least one person with valid CPR and First-Aid certifications on site at all times or present during off site activities, such as field trips.

Exit interview conducted and report was reviewed with the Site Supervisor, Cecilia Esquivel, and Health Services Manager, Ana Aguado.

As a result of today’s inspection, no deficiencies were cited.

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

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process.

LPA requested that the following documents be updated and submitted to the Department:
-Administrative Organization (LIC309)
-Encompass Community Services Board of Trustees
-Personnel Roster (LIC500)
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Cortney Nelson
LICENSING EVALUATOR SIGNATURE:

DATE: 12/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2022
LIC809 (FAS) - (06/04)
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