401710474-9-20-2022-17-CC-EBAY-CJFNDJ-20220920102226

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 401710474
Report Date: 09/20/2022
Date Signed: 09/20/2022 10:23:32 AM

Document Has Been Signed on 09/20/2022 10:23 AM - 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:	BISHOP'S PEAK SCHOOL		FACILITY NUMBER:	401710474
ADMINISTRATOR:	VALERIA MASON-GALE		FACILITY TYPE:	840
ADDRESS:	451 JAYCEE DRIVE		TELEPHONE:	(805) 781-7447
CITY:	SAN LUIS OBISPO	STATE: CA	ZIP CODE:	93405
CAPACITY:	60	CENSUS: 17	DATE:	09/20/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	07:45 AM
MET WITH:	Valerie Mason-Gale		TIME COMPLETED:	09:45 AM

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 9/20/22, at 7:45 AM, Licensing Program Analyst (LPA) Elvin Baddley conducted an unannounced One Year Required inspection the abovementioned Child Care Center (CCC). LPA met with Valerie Mason-Gale, Site Supervisor of the CCC and explained the purpose of the inspection. LPA, in the company of Site Supervisor, toured the interior and exterior of the CCC. The CCC operates out of a module classroom on the grounds of Bishop Elementary School. The CCC's hours of operation are 7:00 AM to 6:00 PM, Monday - Friday, with an AM Program from 7:00 AM -8:15 AM and a PM Program from 2:40 PM- 6:00 PM. During the inspection LPA observed 17 children in the CCC along with two teachers (cleared and associated) providing care and supervision. The classroom of the CCC is organized and clean. The classroom has age appropriate furnishings for children in care. The classroom has an operable refrigerator which contains food items consumed by the CCC's children. Food items in the CCC's refrigerator are labeled. The CCC provided mid day snacks. There is available drinking water fountains for children outside the classroom and bottled water inside. LPA reminded Site Supervisor of the need to have the CCC's water supply tested for lead containments. LPA observed a snack menu posted along with required notices and documents on the classroom's walls. LPA reviewed children's In/Out forms and found the arrival times of children as well as the departure times. The signature of authorized representatives are also noted. LPA observed a carbon monoxide detector on the wall of the classroom which was tested at 8:25 AM and found to be operable. Disinfectants and cleaning solutions are stored in a locked metal cabinet in the corner of the CCC. Sharps are observed secured in a cabinet which is inaccessible to children. Medications is secured in locked cabinet near the classroom entry which is inaccessible to children in care. The restrooms of the CCC are located in a module building outside of the classroom. LPA observed the restrooms to be in sanitary operating condition. In total, four sinks, six toilets and three urinals are available in (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: 09/20/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2022

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

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: BISHOP'S PEAK SCHOOL	FACILITY NUMBER: 401710474
	VISIT DATE: 09/20/2022

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
26
27
28
29
30
31
32

he restroom areas.

The outdoor playground area is enclosed by chain linked and wooden fencing. The fence’s entry/exit gates are secured and furnishings in the area are age appropriate. The play structures in the outdoor play area have adequate cushioning materials to absorb falls. Shade is provided by trees in the area. No bodies of water are observed on site.

Staff and children records were reviewed. The children’s records were complete and found to contain emergency contact information as well admission agreements . Staff records were reviewed and contained current pediatric CPR and First Aid certifications (EMSA approved) along with Mandated Reporter certifications. Site Supervisor noted no firearm or ammunition is stored on site.

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 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.

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 Valerie Mason-Gale.

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Elvin Baddley	TELEPHONE: (805) 635-4697
LICENSING EVALUATOR SIGNATURE:	DATE: 09/20/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2022

LIC809 (FAS) - (06/04)

Page: 2 of 2