401710988-9-15-2021-17-CC-FVEZ-C6VRP7-20210915131128

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 401710988
Report Date: 09/15/2021
Date Signed: 09/15/2021 01:11:33 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:	CAPSLO - FIVE CITIES HEAD START		FACILITY NUMBER:	401710988
ADMINISTRATOR:	A. RAMIREZ-BARRON		FACILITY TYPE:	850
ADDRESS:	1800 WILMAR STREET		TELEPHONE:	(805) 473-1657
CITY:	OCEANO	STATE: CA	ZIP CODE:	93445
CAPACITY:	43	CENSUS: 21	DATE:	09/15/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:15 AM
MET WITH:	Maria Orozco		TIME COMPLETED:	01:20 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 9/15/21, at 11:10 AM, Licensing Program Analyst (LPA) Francisca Velazquez conducted an unannounced Required inspection the Child Care Center (CCC). Prior to entering the facility, LPA and CCC staff conducted COVID-19 pre-screening questionnaire. CCC also conducted temperature check to LPA. LPA met with Maria Orozco, Director of the facility and Veronica Delgado, Family Service Advocate (FSA) of the facility and explained the purpose of the inspection. LPA, in the company of the FSA toured the interior and exterior of the CCC. This CCC is a preschool program. The CCC utilizes two classrooms, Room A known as Extended Day and Room B known as Full Day. This CCC operates from Monday through Friday, Class A offers services from 8:30 AM-3:30 PM and Class B offers services from 7:45 AM through 4:45 PM. At the time of the inspection the CCC has a population of 21 (twenty-one) children in care, along with five (5) teaching staff providing supervision, one (1) cook and one (1) FSA. The classrooms of the CCC are clean and organized. LPA observed licensing required notices posted predominately on the walls near the classroom's entry/exit. The classrooms have age appropriate furnishings and play equipment available for children in care as well as operable carbon monoxide detectors in each classroom. Disinfectants, cleaning supplies are stored in the teacher restroom, and up high by the children sinks. Sharps are secured in cabinets in the CCC classrooms. Medication in the facility is stored in a high cabinet in the kitchen that is locked. All appropriate documentation were stored along with medication. LPA observed menus posted in both English and Spanish in the kitchen. The CCC provides breakfast, lunch and PM snack that are cooked in the agency’s main kitchen and delivered daily to facility. Each child received their plate already served by teaching staff to ensure there is no contamination. Water is available for children both inside and outside of the classroom. The Sign In/Out forms for the CCC were observed near the entry of the classroom by the children’s cubbies. All children present during inspection were signed in correctly. Waste receptacles in the interior and exterior of the CCC are observed to have tight fitting covers. The restrooms used by children in care are clean and free of toxins. Children are escorted to and from the restrooms by the CCC's staff members. Both Class A and Class B, has two (2) toilets and (2) sinks assessable to children in care in each room. CONT 809-C

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisca Velazquez	TELEPHONE: (805) 883-8244
LICENSING EVALUATOR SIGNATURE:	DATE: 09/15/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2021

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: CAPSLO - FIVE CITIES HEAD START	FACILITY NUMBER: 401710988
	VISIT DATE: 09/15/2021

NARRATIVE

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The CCC's outdoor playground areas are enclosed by chain linked fencing. Each classroom has their own fenced yard. LPA observed age appropriate equipment in both playground areas of the facility. The equipment is in suitable condition and free of sharp as well as loose or pointed objects. LPA observed plenty of bark cushioning in the outdoor play area. LPA observed plenty of gross motor activities and shade for children in care. LPA observed no bodies of water on site.

A sampling of staff and children's records were reviewed. The children’s records were complete and found to contain emergency contact information. Staff records were reviewed and found to be current CPR/First Aid certifications as well as, Mandated Reporter training certifications. There are no firearm or ammunition are stored on the site.

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 best practices and guidance. Director was reminded of Director’s responsibility to know the regulations for a CCC which can be accessed on-line at www.ccld.ca.gov.

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: Francisca Velazquez	TELEPHONE: (805) 883-8244
LICENSING EVALUATOR SIGNATURE:	DATE: 09/15/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2021

LIC809 (FAS) - (06/04)

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