TENAYA HEAD START

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25On November 22, 2024, Licensing Program Analysts (LPAs) Yesenia Fierro and Jose Ruiz conducted an unannounced Case Management inspection. LPAs met with Director Belinda Dillon and toured the facility and took a census. LPAs informed Director Belinda Dillon that the purpose for today’s inspection was to follow-up on an unusual incident that was reported to Community Care Licensing (CCL) on November 18, 2024, where child 1 and child 2 walked away from the playground and entered the classroom and administration area unattended. During today’s inspection LPAs conducted staff interviews, based on the information obtained it was determined that there was a lack of supervision which resulted in child 1 and child 2 being unsupervised for approximately 1-3 minutes. Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, the following deficiency is being cited: (see next page, 809 D) Licensee was provided a copy of their appeal rights. LPA Yesenia Fierro informed Director Belinda Dillon that this report dated November 22, 2024, documents one (1) Type A citation which shall be posted for 30 consecutive days as there is immediate risk to the health, safety, or personal rights of children in care. Also, LPA Yesenia Fierro informed Director Belinda Dillon to provide a copy of this licensing report dated November 22, 2024, that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification. Exit interview conducted and report was reviewed with Director Belinda Dillon. A notice of site visit was given and must remain posted for 30 days. SUPERVISORS NAME: Kari McWilliams LICENSING EVALUATOR NAME: Yesenia Fierro LICENSING EVALUATOR SIGNATURE: DATE: 11/22/2024 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/22/2024 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 2 FACILITY NAME: TENAYA HEAD START FACILITY NUMBER: 243810098 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 11/22/2024 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Type A 11/22/2024 Section Cited CCR 101229(a)(1) 1 2 3 4 5 6 7Responsibility for Providing Care and Supervision (a) The licensee shall provide care and supervision as necessary to meet the children's needs. (1) No child(ren) shall be left without the supervision of a teacher at any time... Supervision shall include visual observation. 1 2 3 4 5 6 7Director stated a training will be held regarding care and supervision and will review playground saftey, active supervision and discuss zoning indoor/outdoor and implement new outdoor pick up procedure. 1 2 3 4 5 6 71 2 3 4 5 6 7 1 2 3 4 5 6 71 2 3 4 5 6 7 1 2 3 4 5 6 71 2 3 4 5 6 7 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:Kari McWilliams LICENSING EVALUATOR NAME:Yesenia Fierro LICENSING EVALUATOR SIGNATURE: DATE: 11/22/2024 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/22/2024

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25On November 22, 2024, Licensing Program Analysts (LPAs) Yesenia Fierro and Jose Ruiz conducted an unannounced Case Management inspection. LPAs met with Director Belinda Dillon and toured the facility and took a census. LPAs informed Director Belinda Dillon that the purpose for today’s inspection was to follow-up on an unusual incident that was reported to Community Care Licensing (CCL) on November 18, 2024, where child 1 and child 2 walked away from the playground and entered the classroom and administration area unattended. During today’s inspection LPAs conducted staff interviews, based on the information obtained it was determined that there was a lack of supervision which resulted in child 1 and child 2 being unsupervised for approximately 1-3 minutes. Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, the following deficiency is being cited: (see next page, 809 D) Licensee was provided a copy of their appeal rights. LPA Yesenia Fierro informed Director Belinda Dillon that this report dated November 22, 2024, documents one (1) Type A citation which shall be posted for 30 consecutive days as there is immediate risk to the health, safety, or personal rights of children in care. Also, LPA Yesenia Fierro informed Director Belinda Dillon to provide a copy of this licensing report dated November 22, 2024, that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification. Exit interview conducted and report was reviewed with Director Belinda Dillon. A notice of site visit was given and must remain posted for 30 days. SUPERVISORS NAME: Kari McWilliams LICENSING EVALUATOR NAME: Yesenia Fierro LICENSING EVALUATOR SIGNATURE: DATE: 11/22/2024 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/22/2024 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 2 FACILITY NAME: TENAYA HEAD START FACILITY NUMBER: 243810098 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 11/22/2024 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Type A 11/22/2024 Section Cited CCR 101229(a)(1) 1 2 3 4 5 6 7Responsibility for Providing Care and Supervision (a) The licensee shall provide care and supervision as necessary to meet the children's needs. (1) No child(ren) shall be left without the supervision of a teacher at any time... Supervision shall include visual observation. 1 2 3 4 5 6 7Director stated a training will be held regarding care and supervision and will review playground saftey, active supervision and discuss zoning indoor/outdoor and implement new outdoor pick up procedure. 1 2 3 4 5 6 71 2 3 4 5 6 7 1 2 3 4 5 6 71 2 3 4 5 6 7 1 2 3 4 5 6 71 2 3 4 5 6 7 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:Kari McWilliams LICENSING EVALUATOR NAME:Yesenia Fierro LICENSING EVALUATOR SIGNATURE: DATE: 11/22/2024 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/22/2024

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25On November 22, 2024, Licensing Program Analysts (LPAs) Yesenia Fierro and Jose Ruiz conducted an unannounced Case Management inspection. LPAs met with Director Belinda Dillon and toured the facility and took a census. LPAs informed Director Belinda Dillon that the purpose for today’s inspection was to follow-up on an unusual incident that was reported to Community Care Licensing (CCL) on November 18, 2024, where child 1 and child 2 walked away from the playground and entered the classroom and administration area unattended. During today’s inspection LPAs conducted staff interviews, based on the information obtained it was determined that there was a lack of supervision which resulted in child 1 and child 2 being unsupervised for approximately 1-3 minutes. Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, the following deficiency is being cited: (see next page, 809 D) Licensee was provided a copy of their appeal rights. LPA Yesenia Fierro informed Director Belinda Dillon that this report dated November 22, 2024, documents one (1) Type A citation which shall be posted for 30 consecutive days as there is immediate risk to the health, safety, or personal rights of children in care. Also, LPA Yesenia Fierro informed Director Belinda Dillon to provide a copy of this licensing report dated November 22, 2024, that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification. Exit interview conducted and report was reviewed with Director Belinda Dillon. A notice of site visit was given and must remain posted for 30 days. SUPERVISORS NAME: Kari McWilliams LICENSING EVALUATOR NAME: Yesenia Fierro LICENSING EVALUATOR SIGNATURE: DATE: 11/22/2024 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/22/2024 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 2 FACILITY NAME: TENAYA HEAD START FACILITY NUMBER: 243810098 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 11/22/2024 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Type A 11/22/2024 Section Cited CCR 101229(a)(1) 1 2 3 4 5 6 7Responsibility for Providing Care and Supervision (a) The licensee shall provide care and supervision as necessary to meet the children's needs. (1) No child(ren) shall be left without the supervision of a teacher at any time... Supervision shall include visual observation. 1 2 3 4 5 6 7Director stated a training will be held regarding care and supervision and will review playground saftey, active supervision and discuss zoning indoor/outdoor and implement new outdoor pick up procedure. 1 2 3 4 5 6 71 2 3 4 5 6 7 1 2 3 4 5 6 71 2 3 4 5 6 7 1 2 3 4 5 6 71 2 3 4 5 6 7 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:Kari McWilliams LICENSING EVALUATOR NAME:Yesenia Fierro LICENSING EVALUATOR SIGNATURE: DATE: 11/22/2024 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/22/2024

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25On November 22, 2024, Licensing Program Analysts (LPAs) Yesenia Fierro and Jose Ruiz conducted an unannounced Case Management inspection. LPAs met with Director Belinda Dillon and toured the facility and took a census. LPAs informed Director Belinda Dillon that the purpose for today’s inspection was to follow-up on an unusual incident that was reported to Community Care Licensing (CCL) on November 18, 2024, where child 1 and child 2 walked away from the playground and entered the classroom and administration area unattended. During today’s inspection LPAs conducted staff interviews, based on the information obtained it was determined that there was a lack of supervision which resulted in child 1 and child 2 being unsupervised for approximately 1-3 minutes. Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, the following deficiency is being cited: (see next page, 809 D) Licensee was provided a copy of their appeal rights. LPA Yesenia Fierro informed Director Belinda Dillon that this report dated November 22, 2024, documents one (1) Type A citation which shall be posted for 30 consecutive days as there is immediate risk to the health, safety, or personal rights of children in care. Also, LPA Yesenia Fierro informed Director Belinda Dillon to provide a copy of this licensing report dated November 22, 2024, that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification. Exit interview conducted and report was reviewed with Director Belinda Dillon. A notice of site visit was given and must remain posted for 30 days. SUPERVISORS NAME: Kari McWilliams LICENSING EVALUATOR NAME: Yesenia Fierro LICENSING EVALUATOR SIGNATURE: DATE: 11/22/2024 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/22/2024 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 2 FACILITY NAME: TENAYA HEAD START FACILITY NUMBER: 243810098 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 11/22/2024 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Type A 11/22/2024 Section Cited CCR 101229(a)(1) 1 2 3 4 5 6 7Responsibility for Providing Care and Supervision (a) The licensee shall provide care and supervision as necessary to meet the children's needs. (1) No child(ren) shall be left without the supervision of a teacher at any time... Supervision shall include visual observation. 1 2 3 4 5 6 7Director stated a training will be held regarding care and supervision and will review playground saftey, active supervision and discuss zoning indoor/outdoor and implement new outdoor pick up procedure. 1 2 3 4 5 6 71 2 3 4 5 6 7 1 2 3 4 5 6 71 2 3 4 5 6 7 1 2 3 4 5 6 71 2 3 4 5 6 7 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:Kari McWilliams LICENSING EVALUATOR NAME:Yesenia Fierro LICENSING EVALUATOR SIGNATURE: DATE: 11/22/2024 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/22/2024

Type A citation - immediate risk to health, safety, or personal rights

Type B citation - potential risk if not corrected