401702641-8-19-2021-17-CC-EBAY-C62RSA-20210819131625

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 401702641
Report Date: 08/19/2021
Date Signed: 08/19/2021 01:16:35 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME:	ORFALEA FAMILY & ASI CHILDREN'S CENTER RM # 133		FACILITY NUMBER:	401702641
ADMINISTRATOR:	ASHLEY SHOALS		FACILITY TYPE:	850
ADDRESS:	1 GRAND AVE		TELEPHONE:	(805) 756-1267
CITY:	SAN LUIS OBISPO	STATE: CA	ZIP CODE:	93407
CAPACITY:	96	CENSUS: 27	DATE:	08/19/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Ashley Shoals		TIME COMPLETED:	11:15 AM

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On 8/19/21, at 9:15 AM, Licensing Program Analysts (LPA) Elvin Baddley conducted an unannounced Required Inspection the abovementioned Child Care Center (CCC). LPA met with Ashley Shoals, Director of the CCC and explained the purpose of the inspection. LPA, in the company of Director, toured the interior and exterior of the CCC. The CCC operates from 8:00 AM to 5:00 PM, Monday - Friday. The preschool uses four classrooms (Room Four- ages 2-3 years old, Room Five- ages 3-4 years old, Room Six ages 4-5 year old and Room Seven ages 5-6 year old) for child care. LPA observed 27 children on site during the inspection along with 15 teachers (cleared and associated). The CCC is a combination preschool infant program.

The classrooms of the CCC are clean, orderly and organized. Each classroom has appropriate toys and furnishings available for children in care at the room's given age range. The CCC has an operable carbon monoxide detector which was tested (11:45 AM). The bathrooms in the CCC are attached to the classrooms. LPA observed the bathrooms to be in safe and sanitary operating condition. LPA observed operable refrigerators in each classroom. The refrigerator contained items for the children consumption. Refrigerated food items are observed labeled. LPA notes the CCC provided snacks, breakfast and lunches for children in care. LPA also observed a posted menu near the CCC entry door.

Disinfectants, cleaning solutions and medications are stored on elevated shelves in classroom cabinets which are beyond the reach of children in care. The CCC also has cleaning supplies in the kitchen area which is excluded from care and inaccessible to children in care. LPA observed sharps in the classrooms on elevated shelves, beyond the reach of children in care.

The CCC has outdoor play areas attached to each classroom. The play yards are enclosed by a combination of chain linked, cider block and vinyl fencing. The play yards fences' entry/exit gates are secured. The footing in the area consist of artificial grass, natural grass, sand and concrete. LPA observed age appropriate toys and play equipment in the playground areas is varied. The toys and play equipment are in suitable condition and free of sharp, loose or pointed objects. The play structures in the areas have adequate

(CONT.809-C)

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Elvin Baddley	TELEPHONE: (805) 635-4697
LICENSING EVALUATOR SIGNATURE:	DATE: 08/19/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2021

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, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: ORFALEA FAMILY & ASI CHILDREN'S CENTER RM # 133	FACILITY NUMBER: 401702641
	VISIT DATE: 08/19/2021

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cushioning materials to absorb for falls and an abundance of shade created by trees, shade sails and building overhangs. LPA observed no bodies of water on site. There is available drinking water for children both inside the classroom and outside in the play area. Waste receptacles with tight fitting covers are observed throughout the center.

LPA observed licensing required notices and documents posted predominately on the wall near the CCC's main entry. LPA reviewed Sign In/Out forms upon arrival at the CCC and found the forms to be completed appropriately.

A sampling of staff and children's records are reviewed. The children’s records were complete and found to contain emergency contact information as well as immunizations. Staff records were reviewed and contained current pediatric First Aid/CPR certifications as well as certifications for Mandated Reporter. Director informed LPA no firearm or ammunition is stored on the premises.

This facility provides Incidental Medical Services (IMS). LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. The following information regarding ADA was provided: US Department of Justice (USDOJ) 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 COVID 19 guidance and best practices with the Director. LPA also discussed the placement of sharps in the classroom and secured cabinetry versus unsecured cabinetry. Director is reminded that it is Director's responsibility to know the regulations for a CCC which can be accessed on-line at www.ccld.ca.gov.

In areas evaluated, there were no deficiencies cited at this time.

THE NOTICE OF SITE VISIT WAS POSTED AS REQUIRED BY H&S CODE SEC. 1596.817. THE NOTICE OF SITE VISIT MUST REMAIN POSTED FOR 30 DAYS OR A CIVIL PENALTY OF $100.00 WILL APPLY .

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Elvin Baddley	TELEPHONE: (805) 635-4697
LICENSING EVALUATOR SIGNATURE:	DATE: 08/19/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2021

LIC809 (FAS) - (06/04)

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