401702641-12-13-2022-17-CC-EBAY-CM3UDC-20221213142919

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 401702641
Report Date: 12/13/2022
Date Signed: 12/13/2022 02:32:49 PM

Document Has Been Signed on 12/13/2022 02:32 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, 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: 55	DATE:	12/13/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:01 PM
MET WITH:	Ashley Shoals		TIME COMPLETED:	02:45 PM

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On 12/13/22, at 12:01 PM, Licensing Program Analyst (LPA) Elvin Baddley conducted an unannounced One Year 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 7:30 AM to 5:30 PM, Monday - Friday. The preschool uses four classrooms for child care. LPA observed 55 children during the inspection, along with 15 teachers (cleared and associated) providing care and supervision. The facility is an infant preschool combination center and the infant program maintains a separate license (#401702793).

The classrooms of the CCC are clean and organized. Each classroom has appropriate toys and furnishings available for children in care. The CCC has an operable carbon monoxide detector which was tested (12:30 PM). 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 miniature refrigerators in each classroom. The refrigerator contained items for the children consumption. LPA notes the CCC provided snacks, breakfast and lunches for children in care. The facility has water available for the children to access inside of the CCC and in the outdoor play yard. Water sources at the CCC have been tested for lead containments. LPA also observed a posted menu near the CCC entry door. Disinfectants, cleaning solutions, medications and sharps are stored on elevated shelves in classroom cabinets which are beyond the reach of children in care and inaccessible. The CCC also has cleaning supplies in the kitchen area which is excluded from care and inaccessible to children in care. LPA observed licensing required forms, documents and notices posted at the CCC. LPA reviewed Sign In/Out forms at the CCC. The forms contained the arrival and departure times of children along with the signature of authorized representatives.

The CCC outdoor play areas are attached to each classroom. The areas are enclosed by a combination of chain linked, cider block and vinyl fencing. The footing in the areas are varied. The play yards fences' entry/exit gates are secured. LPA observed age appropriate toys and play equipment in the play areas. The toys and play equipment are in suitable condition and free of sharp, loose or pointed objects. The play

(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: 12/13/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/13/2022

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

FACILITY NAME: ORFALEA FAMILY & ASI CHILDREN'S CENTER RM # 133	FACILITY NUMBER: 401702641
	VISIT DATE: 12/13/2022

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structures in the areas have adequate cushioning to absorb falls. LPA reminded the Director to replace toys and play equipment when such items begin to degrade and are not in good repair. LPA observed an abundance of shade created by trees, shade sails and building overhangs in the play yards. LPA observed no bodies of water on site. Waste receptacles with tight fitting covers are observed throughout the center.

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 immunization records. Staff records were reviewed and contained current pediatric First Aid/CPR certifications (EMSA Approved) as well as certifications for Mandated Reporter. Director informed LPA no firearm or ammunition is stored on the premises.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 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 (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

Facility representative were 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.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Facility representative Ashley Shoals

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Elvin Baddley	TELEPHONE: (805) 635-4697
LICENSING EVALUATOR SIGNATURE:	DATE: 12/13/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/13/2022

LIC809 (FAS) - (06/04)

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