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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 444410798
Report Date: 08/22/2024
Date Signed: 08/26/2024 10:23:02 AM

Document Has Been Signed on 08/26/2024 10:23 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:STARLIGHT CHILDREN'S CENTERFACILITY NUMBER:
444410798
ADMINISTRATOR/
DIRECTOR:		ELIZABETH TAPIAFACILITY TYPE:
830
ADDRESS:360 ARTHUR ROADTELEPHONE:
(831) 724-3885
CITY:WATSONVILLESTATE: CAZIP CODE:
95076
CAPACITY: 16TOTAL ENROLLED CHILDREN: 16CENSUS: 10DATE:
08/22/2024
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:48 PM
MET WITH:Elizabeth TapiaTIME VISIT/
INSPECTION COMPLETED:
04:45 PM
NARRATIVE
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This is an amended report.
At 1:45 PM., Licensing Program Analyst (LPA) Teodoro Trujillo, conducted an unannounced case management inspection to discuss a water lead testing complaint. LPA met with Site Director (SD) Elizabeth Tapia and explained the purpose for the inspection. During the site visit, Site Supervisor (SS) Estela Rodrguez, SS Lupita Garcia arrived during the visit. LPA and SD, SS conducted a tour of the facility. On July 25, 2024 water testing was done by Monterey Bay Analytical Services.

LPA observed bottled water is being provided for drinking and food preparation. SD will insure bottle water will be provide to the children until test is completed and results are submitted to the department. Lunches are provide by Chefables that provide the meals. SS Estela stated remediation for the water faucets, SCC1 (Infants), SCC2 (toddlers) have been replaced and currently started the daily flushing of faucets on 08/21/24 and will retest in 21 days.

The following documents were explained to SD during today's inspection:
1) External Water Sampler Self-Certification Form (LIC9275).
2) Childcare Center Sampling Checklist Form (LIC9276).
3) Facility Sketch (LIC999) labeled with locations of water outlets that were tested.

Type B deficiency was cited and exit interview conducted

A NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 DAYS.
SUPERVISORS NAME: Susy Cervantes
LICENSING EVALUATOR NAME: Teodoro Trujillo
LICENSING EVALUATOR SIGNATURE: DATE: 08/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/22/2024
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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Document Has Been Signed on 08/26/2024 10:24 AM - It Cannot Be Edited

Document is an Amendment of Original Document on 08/23/2024 05:20 PM


Created By: Teodoro Trujillo On 08/22/2024 at 03:52 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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: STARLIGHT CHILDREN'S CENTER
FACILITY NUMBER: 444410798

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/22/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/12/2024
Section Cited
CCR
101700.3(b)(2)

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Lead Testing Written Directives (b)(1) a result with values of 5.5 parts per billion or greater shall be deemed an Action Level Exceedance (ALE).

This requirement is not met as evidenced by:
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The facility has completely replaced both faucets SCC1 and SCC2 and started the 21 day required flushing. The facility shall contact (CRWA) to label the sink faucets correctly. Facility shall retest faucets "SCC1 and SCC2) and notify Licensing once it has been
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After water lead testing was completed, the facility had faucet (SCC1) and SCC2 located in the Infant and toddler sink with an Action Level Exceedance of 11.5 and 18.2 which poses a potenial risk to the health, safety, and personal rights of children in care.
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completed by plan of correction by POC due date 09/12/2024.

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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:Susy Cervantes
LICENSING EVALUATOR NAME:Teodoro Trujillo
LICENSING EVALUATOR SIGNATURE:
DATE: 08/22/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/22/2024


LIC809 (FAS) - (06/04)
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