401710899-3-7-2022-17-CC-EBAY-CCB2KZ-20220307162847

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 401710899
Report Date: 03/07/2022
Date Signed: 03/07/2022 04:28:52 PM

Document Has Been Signed on 03/07/2022 04:28 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:	DEL MAR ELEMENTARY SCHOOL - KID'S CLUB		FACILITY NUMBER:	401710899
ADMINISTRATOR:	ANGELICA GALLARDO		FACILITY TYPE:	840
ADDRESS:	501 SEQUOIA, ROOM 25		TELEPHONE:	(805) 772-6278
CITY:	MORRO BAY	STATE: CA	ZIP CODE:	93442
CAPACITY:	50	CENSUS: 16	DATE:	03/07/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:45 PM
MET WITH:	Angelica Gallardo		TIME COMPLETED:	04:30 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 3/7/22, at 1:45 PM, Licensing Program Analyst (LPA) Elvin Baddley conducted an unannounced Required Annual inspection of the abovementioned Child Care Center (CCC). LPA met with Angelica Gallardo, Director of the CCC and explained the purpose of the inspection. LPA, in the company of the Director, toured the interior and exterior of the CCC. The CCC is located in a single classroom on the grounds of Del Mar Elementary School. The CCC operates from 7:00 AM to 10:00 AM and 12:00 PM to 6:00 PM, Monday - Friday. The CCC has a population of 16 children in care at the time of the inspection along with 4 teachers providing care and supervision. The classroom has age appropriate equipment and furnishings available to children in care. LPA observed a carbon monoxide detector in classroom which was tested at 2:30 PM and found to be operable. There are 3 restrooms used by the children in care. All restrooms are in sanitary operating condition. LPA observed an operable refrigerator in the classroom which contained food for the children. The parents of children in care provide snacks, however the CCC has food in reserve for children should the need arise. The CCC also has available (filtered) water for children inside and outside of the facility. Disinfectants and cleaning solutions are observed in a locked cabinet underneath a sink in the CCC The CCC's medications are stored in Del Mar Elementary School Nurse's office. LPA reviewed a posted menu on the classroom's wall as well as required licensing notices and documents The Sign In/Out form for children in care was reviewed upon arrival and found to be appropriate. The CCC outdoor playground areas are enclosed by chain linked fencing. The fence’s entry/exit gates are secured. LPA observed age appropriate toys/play equipment in the play areas. The toys/play equipment are free of sharp, loose or pointed objects. The play structures in the playground areas have adequate cushioning materials in the form of wooden chips to absorb falls. No bodies of water are observed on site. LPA notes a fenced play yard is also outside of the classroom which is also for outdoor activities. (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: 03/07/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2022

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: DEL MAR ELEMENTARY SCHOOL - KID'S CLUB	FACILITY NUMBER: 401710899
	VISIT DATE: 03/07/2022

NARRATIVE

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A sampling of staff and children records were reviewed. The children’s records were complete and found to contain emergency contact information. Staff records were reviewed and contained documentation to support CPR/First Aid training . Director noted no firearms 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 Angelica Gallardo

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Elvin Baddley	TELEPHONE: (805) 635-4697
LICENSING EVALUATOR SIGNATURE:	DATE: 03/07/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2022

LIC809 (FAS) - (06/04)

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