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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 444400153
Report Date: 08/11/2022
Date Signed: 08/11/2022 02:49:41 PM

Document Has Been Signed on 08/11/2022 02:49 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 PRESCHOOL MIGRANT & SEASONAL HEAD STARTFACILITY NUMBER:
444400153
ADMINISTRATOR:ANGELICA RENTERIAFACILITY TYPE:
850
ADDRESS:125 ALTA VISTA AVE.TELEPHONE:
(831) 761-6179
CITY:WATSONVILLESTATE: CAZIP CODE:
95076
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 23DATE:
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 23 preschool-age children and 5 staff (4 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. Sign-in/out was observed to be completed with full legal signature and time of day. The last fire drill was conducted on 7/6/2022, 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 Supervisor states that she currently has children in care who require Incidental Medical Services for nebulizers. LPA observed nebulizers are properly stored out of reach of children, in a locked box, with the proper documentation. 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

LPA discussed the safe sleep regulations with 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.
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)
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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 PRESCHOOL MIGRANT & SEASONAL HEAD START
FACILITY NUMBER: 444400153
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 the day care children. LPA observed sufficient age-appropriate materials, toys, and play equipment in the facility. The floors were 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. Children's bathroom was observed to be equipped with a diaper changing table that is near a functioning sink and waste basket with tight fitting lid. There is a separate staff bathroom, not utilized by the children, which an isolated child can use if necessary.

Food is provided by the facility and is stored, prepared, and served in a safe and healthful manner to the children. Facility offers a full day program and provides breakfast, lunch, & AM/PM snack to children. LPA observed 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. Equipment necessary for the storage, preparation and service of food is well maintained, clean, and sanitized after each use.

The outdoor area of the facility was inspected and observed to be fenced in. Fence was observed to have damage that will need repairs and Site Supervisor states that a repair order has been submitted. LPA reviewed work order during todays inspection. LPA observed play equipment for children was in good condition, age-appropriate, and has sufficient resilient materials (tanbark) to absorb falls. Outside area is equipped with various activities for children such as playground, sandbox, watertables, and play house. No outdoor bodies of water were observed during today’s inspection. There are 3 functioning sinks located outside for children to wash hands. Shaded rest area is provided by canopy.

10 preschool-age children’s files were reviewed during today’s inspection and all required documents were present. 5 staff files 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.
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 PRESCHOOL MIGRANT & SEASONAL HEAD START
FACILITY NUMBER: 444400153
VISIT DATE: 08/11/2022
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The Site Supervisor understands that she 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 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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