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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 445202354
Report Date: 11/25/2024
Date Signed: 11/25/2024 03:44:47 PM

Document Has Been Signed on 11/25/2024 03:44 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
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131
FACILITY NAME:BRIGHTPATH COMMUNITY CENTERFACILITY NUMBER:
445202354
ADMINISTRATOR/
DIRECTOR:		VICTOR CORTESFACILITY TYPE:
775
ADDRESS:720 CAPITOLA AVENUE, SUITE ETELEPHONE:
(831) 476-1465
CITY:CAPITOLASTATE: CAZIP CODE:
95010
CAPACITY: 20CENSUS: 18DATE:
11/25/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:45 AM
MET WITH:Administrator-Victor CortesTIME VISIT/
INSPECTION COMPLETED:
04:00 PM
NARRATIVE
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Licensing Program Analyst (LPA) Marcella Tarin conducted an unannounced annual inspection and met with Administrator (ADM) Victor Cortes. LPA toured the interior and exterior with ADM to include kitchen, indoor activity area, restrooms, storage area in kitchen, and staff office. LPA observed 18 clients engaged in morning activities in the indoor activity area with 6 staff. All 6 staff obtained background fingerprint clearance.

At 10:05 AM LPA toured the kitchen area and observed all chemicals and sharps to be locked in the kitchen storage room inaccessible to clients. LPA measured kitchen water temperature at 117.6 F. LPA observed the kitchen dishwasher to have metal parts exposed. LPA observed kitchen windows and screens to have visible dirt and particles and cobwebs. LPA advised ADM to have the dishwasher repaired due to metal parts being exposed and to clean the kitchen windows and screens.

Fire extinguishers were last serviced on 09/23/2024. Facility smoke detectors functioned properly when tested. LPA observed the facility first aid kit and it was observed to be complete. The facility fire/earthquake drill log was reviewed and drills are not being conducted. ADM states no drills have been conducted for 2024. LPA advised ADM that facility drills shall be conducted at least every six months.

At 10:15 AM LPA toured 2 client bathrooms. 2 out of 2 bathrooms were observed with cobwebs around the windows and on the ceiling, and visible dirt and particles on the indoor window screens/covers. In bathroom #1, LPA observed damaged unpainted areas on the wall, a patched white area and a damaged handrail (pictures taken). In bathroom #2, 2 glasses panes were observed missing from a window, allowing rain into the bathroom. ADM states these areas were damaged last month and would be repairing the noted areas by 12/6/2024.

See LIC809C
SUPERVISORS NAME: Jin Jackie
LICENSING EVALUATOR NAME: Marcella Tarin
LICENSING EVALUATOR SIGNATURE: DATE: 11/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/25/2024
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 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131
FACILITY NAME: BRIGHTPATH COMMUNITY CENTER
FACILITY NUMBER: 445202354
VISIT DATE: 11/25/2024
NARRATIVE
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LPA reviewed client records. 7 out of 7 client records were observed to be complete, records included name of clients, medical assessments, needs/service plans and emergency contact information.

LPA reviewed 7 staff records. 6 out of 7 staff records were observed to be complete and included background fingerprint clearance, TB results, staff training and CPR/First Aid training. Staff S1 did not obtain the minimum of 30 clock hours of continuing education every 24 months of employment. LPA advised ADM a minimum of 30 clock hours of continuing education are required to ensure the health and safety of clients in care.

Deficiencies were cited today as per California Code of Regulations Title 22. See LIC809-D. Exit interview was conducted with Administrator Victor Cortes. A copy of this report was provided to Administrator and Appeal Rights were provided.
SUPERVISORS NAME: Jin Jackie
LICENSING EVALUATOR NAME: Marcella Tarin
LICENSING EVALUATOR SIGNATURE:

DATE: 11/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/25/2024
LIC809 (FAS) - (06/04)
Page: 5 of 5
Document Has Been Signed on 11/25/2024 03:44 PM - It Cannot Be Edited


Created By: Marcella Tarin On 11/25/2024 at 02:40 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. 350
SAN JOSE, CA 95131

FACILITY NAME: BRIGHTPATH COMMUNITY CENTER
FACILITY NUMBER: 445202354

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/25/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
82087(a)
Buildings and Grounds
(a) The program site shall be clean, safe, sanitary and in good repair at all times for the safety and well-being of clients, employees and visitors.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation the licensee did not comply with the section cited above. LPA observed the kitchen dishwasher to have metal parts exposed, kitchen windows with cobwebs, and cobwebs throughout facility. LPA observed bathroom #1 to have damaged walls and handrail. Bathroom #2 window was missing glass panels which poses an immediate health, safety or personal rights risk to persons in care. During visit, ADM purchased new dishwasher to be installed by 11/26/2024.
POC Due Date: 11/26/2024
Plan of Correction
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Licensee will submit a plan of correction to include a statement of understanding regarding the regulation cited and an in-service training regarding the facility being in good repair at all times for the safety and well-being of the clients, employees and visitors. Licensee will also submit pictures of new dishwasher installed. Licensee will submit POC by POC due date 11/26/2024.
Type A
Section Cited
CCR
82064(d)
Administrator -Qualifications and Duties
(d) The administrator shall receive and document a minimum of 30 clock hours of continuing education every 24 months of employment.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review, the licensee did not comply with the section cited above. Staff S1 did not obtain the minimum of 30 clock hours of continuing education every 24 months of employment required for the role of administrator which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 11/26/2024
Plan of Correction
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Licensee will submit a plan of correction to include a statement of understanding about the regulation cited. Administrator will also submit proof of continuing education to LPA Tarin by 12/6/2024.
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:Jin Jackie
LICENSING EVALUATOR NAME:Marcella Tarin
LICENSING EVALUATOR SIGNATURE:
DATE: 11/25/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/25/2024


LIC809 (FAS) - (06/04)
Page: 2 of 5
Document Has Been Signed on 11/25/2024 03:44 PM - It Cannot Be Edited


Created By: Marcella Tarin On 11/25/2024 at 02:40 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. 350
SAN JOSE, CA 95131

FACILITY NAME: BRIGHTPATH COMMUNITY CENTER
FACILITY NUMBER: 445202354

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/25/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
82023(d)
Disaster and Mass Casualty Plan
(d) Disaster drills shall be conducted at least every six months.

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. The facility fire/earthquake drill log was reviewed and drills are not being conducted. ADM states no drills have been conducted for 2024, which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 11/26/2024
Plan of Correction
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Licensee will submit a plan of correction to include a statement of understanding of the regulation cited and to conduct an in-service staff training on 11/27/2024, to include an emergency drill with staff and submit documentation to LPA Tarin via email by POC due date 11/26/2024.
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:Jin Jackie
LICENSING EVALUATOR NAME:Marcella Tarin
LICENSING EVALUATOR SIGNATURE:
DATE: 11/25/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/25/2024


LIC809 (FAS) - (06/04)
Page: 3 of 5
Document Has Been Signed on 11/25/2024 03:44 PM - It Cannot Be Edited


Created By: Marcella Tarin On 11/25/2024 at 02:40 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. 350
SAN JOSE, CA 95131

FACILITY NAME: BRIGHTPATH COMMUNITY CENTER
FACILITY NUMBER: 445202354

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/25/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
82023(d)(2)
Disaster and Mass Casualty Plan
(d) Disaster drills shall be conducted at least every six months. (2) The drills shall be documented and the documentation maintained in the day program for at least one year.

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. LPA reviewed the facility fire/earthquake drill log and observered drills were not conducted for 2024. ADM states no drills have been conducted for 2024 which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/26/2024
Plan of Correction
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Licensee will submit a plan of correction to include a statement of understanding of the regulation cited. Licensee will also conduct an emergency drill by 11/27/2024. Licensee states the facility will have an in-service training on 11/27/2024 and submit documentation to LPA Tarin via email by POC due date 111/26/2024.
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:Jin Jackie
LICENSING EVALUATOR NAME:Marcella Tarin
LICENSING EVALUATOR SIGNATURE:
DATE: 11/25/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/25/2024


LIC809 (FAS) - (06/04)
Page: 4 of 5