401710471-6-7-2021-17-CC-EBAY-C3RV4N-20210607160634

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 401710471
Report Date: 06/07/2021
Date Signed: 06/07/2021 04:08:20 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:	C.L. SMITH SCHOOL		FACILITY NUMBER:	401710471
ADMINISTRATOR:	VALERIE BADA		FACILITY TYPE:	840
ADDRESS:	1375 BALBOA		TELEPHONE:	(805) 544-7744
CITY:	SAN LUIS OBISPO	STATE: CA	ZIP CODE:	93401
CAPACITY:	65	CENSUS: 21	DATE:	06/07/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:15 PM
MET WITH:	Valerie Baca		TIME COMPLETED:	04:00 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 6/7/21, at 1:15 PM, Licensing Program Analyst (LPA) Elvin Baddley and LPA Francisca Velazquez conducted an unannounced Required inspection the abovementioned Child Care Center (CCC). LPAs met with Valerie Bada, Director of the CCC and explained the nature and purpose of the inspection. LPAs, in the company of Director, toured the interior and exterior of the CCC. The center is a School Age program which use three classrooms on the ground of C.L. Smith Elementary school. At the time of the inspection the CCC has a population of 21 children in care. The classrooms of the CCC (Blue Room , Purple Room , Green Room) were clean and organized. The classrooms had age appropriate furnishings and play equipment available for children. Each classroom has operable carbon monoxide detectors which were tested ( 2:03 PM, 2:12 PM , 2:19 PM). The bathrooms used by children are in safe and sanitary operating condition. Disinfectants, cleaning solutions and sharps are locked in a storage room in the CCC’s Purple Room. Likewise, the CCC’s medications, when on site, are locked in the same storage room. The center provides snacks for the children twice a day. Lunch is not served at the School Age program, however children in care bring lunch from their residence. LPAs reviewed posted menus in the classroom which outlined the future snacks to be provided. Additionally, licensing required notices are posted predominately near the entry of the CCC along with Sign In/Out forms. LPAs noted the Sign In/Out forms were completed appropriately. The CCC's outdoor playground areas, which are comprised of grass, a blacktop and place structure area is enclosed by chain linked fencing. LPAs observed age appropriate play equipment in the outdoor area. The play equipment are in suitable condition and free of sharp as well as loose or pointed objects. The play structures in the playground area has adequate cushioning materials (i.e. wood chips) to absorb falls and an abundance of shade (i.e. tress). No bodies of water were observed on site. There is available drinking water for children both inside and outside of the classroom. Children also bring their own drinking water (CONT. LIC 809-C)

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Elvin Baddley	TELEPHONE: (805) 635-4697
LICENSING EVALUATOR SIGNATURE:	DATE: 06/07/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2021

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: C.L. SMITH SCHOOL	FACILITY NUMBER: 401710471
	VISIT DATE: 06/07/2021

NARRATIVE

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the CCC. Waste receptacles with tight fitting covers are observed throughout the center.

A sampling of staff and children records were reviewed. The children’s records were complete and found to contain emergency contact information as well as medical assessments. Staff records were reviewed and contained health assessments. Director noted no firearms/weapons or ammunition are 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

In areas evaluated, no deficiencies observed.

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: 06/07/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2021

LIC809 (FAS) - (06/04)

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