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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 444400150
Report Date: 08/11/2022
Date Signed: 08/11/2022 02:50:33 PM

Document Has Been Signed on 08/11/2022 02:50 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:H.A. HYDE INFANT MIGRANT & SEASONAL HEAD START.FACILITY NUMBER:
444400150
ADMINISTRATOR:ANGELICA RENTERIAFACILITY TYPE:
830
ADDRESS:125 ALTA VISTA AVE.TELEPHONE:
(831) 761-6179
CITY:WATSONVILLESTATE: CAZIP CODE:
95076
CAPACITY: 16TOTAL ENROLLED CHILDREN: 16CENSUS: 15DATE:
08/11/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:17 AM
MET WITH:Maria Garcia & Maria CortesTIME COMPLETED:
03:00 PM
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Licensing Program Analyst (LPA), Cortney Nelson, met with Site Supervisor, Maria Garcia, and Child Development Coordinator, Maria Cortes, for an unannounced Required- 1 Year Inspection. LPA was granted access to the facility by the Site Supervisor and toured both indoors and outdoors during the inspection. Upon arrival,
there were 15 infants and 8 staff (7 teachers & site supervisor) present, which is compliant with the facility license capacity and ratio requirements. LPA observed all required postings near the entrance to the facility. Hours of operation for the facility are Monday – Friday, 6:00AM-6:00PM.

LPA reviewed sign-in/out sheets, facility roster (LIC9040), and fire/disaster drill log during today’s inspection. The last fire drill was conducted on 8/9/2022, which is compliant with the six-month requirement for facilities. LPA observed a fully charged 3A40BC fire extinguisher (last serviced: 5/2022), functioning smoke detector and carbon monoxide detector. Site Director states that she does not currently have any children in care who require Incidental Medical Services and does not administer medication at this time. The Site Supervisor states that there are no weapons or firearms on the premises.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual- Regulation Interpretations and Procedures for Child Care Centers, Section 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. 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: 08/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/11/2022
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 3
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: H.A. HYDE INFANT MIGRANT & SEASONAL HEAD START.
FACILITY NUMBER: 444400150
VISIT DATE: 08/11/2022
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Indoor areas of the facility were inspected by the LPA today and observed to be clean, orderly, and safe for day care infants. Infant room at the facility is physically separate from the preschool component. LPA observed sufficient age-appropriate materials, toys, and play equipment in the facility. Toys are safe and do not have sharp edges or small parts that may pose a choking hazard. Two infant changing tables were observed to be padded, within arms reach of a sink, in good repair and safe condition. The floors are clean and free of tripping hazards and waste containers have tight fitting lids. Cribs used by the infants are free from loose articles, covered with a fitted sheet, and there are no objects hanging above or attached to the crib. Napping area equipped with four (4) cribs is separated by clear partition walls from the activity area for infants.

All infants have current Needs and Services plan that has been updated quarterly. Feeding plan is current for all infants and LPA observed that all formula and bottles were properly labeled with the child’s name and date.

LPA discussed the safe sleep regulations with the Site Supervisor and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource.

The outdoor area of the facility was inspected and observed to be fenced in and physically separated from space utilized by the component. LPA observed play equipment was in good condition, age-appropriate, and has sufficient resilient materials (rubber padding) to absorb falls. Outdoor play area is separated into two smaller areas, both equipped with playground for infants and various manipulative activity areas. No outdoor bodies of water were observed during today’s inspection. Shaded rest area is provided by canopy. There are three (3) functioning sinks located outside for infants to wash hands.

10 infant files were reviewed during today’s inspection and all required documents were present including Individual Infant Sleep Plan (LIC9227) and documented nap checks.
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Cortney Nelson
LICENSING EVALUATOR SIGNATURE:

DATE: 08/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/11/2022
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: H.A. HYDE INFANT MIGRANT & SEASONAL HEAD START.
FACILITY NUMBER: 444400150
VISIT DATE: 08/11/2022
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8 staff files (1 director/7 teachers) were reviewed and all required documents were present. The Site Supervisor has current CPR/First-Aid that expires 3/20/2023 and Mandated Reporter Training that expires on 8/25/2023. LPA reminded the Site Supervisor that both trainings must be renewed every 2 years.

The Site Supervisor was reminded that all adults 18 and over, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

The Site Supervisor understands that she shall be on the premises during the hours the center is in operation and that infants 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 Child Development Coordinator, Maria Cortes.

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.
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Cortney Nelson
LICENSING EVALUATOR SIGNATURE:

DATE: 08/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/11/2022
LIC809 (FAS) - (06/04)
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