401711246-5-31-2022-17-CC-EBAY-CEXV3D-20220531160434

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 401711246
Report Date: 05/31/2022
Date Signed: 05/31/2022 04:04:41 PM

Document Has Been Signed on 05/31/2022 04:04 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:	CHILD'S SMILE PRESCHOOL		FACILITY NUMBER:	401711246
ADMINISTRATOR:	SHIRLEY ALBRECHT		FACILITY TYPE:	850
ADDRESS:	781 PAUL PLACE		TELEPHONE:	(805) 234-6988
CITY:	ARROYO GRANDE	STATE: CA	ZIP CODE:	93420
CAPACITY:	28	CENSUS: 4	DATE:	05/31/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	02:30 PM
MET WITH:	Laura Karlyn-Viger		TIME COMPLETED:	04:30 PM

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On 5/31/22, at 2:30 PM, Licensing Program Analyst (LPA) Elvin Baddley conducted an unannounced One Year Required Inspection of the abovementioned Child Care Center (CCC). The LPA met with Laura Karlyn-Viger, Director of the CCC and explained the purpose of the inspection. The LPA toured the interior and exterior of the CCC. The CCC operates from 7:30 AM-5:30 PM, Monday- Friday. LPA observed four children on site, one napping, during the inspection.

LPA observed age appropriate toys and furnishings available for children in care in the CCC. The CCC has a carbon monoxide detector. The detector was not tested as a child in care is napping. The detector will be tested post inspection. The restroom used by children in care is in safe and sanitary operating condition. LPA observed an operable refrigerator in the CCC which contains items consumed by children in care. LPA notes snacks are provided by the CCC while the parents of children in care provide lunches. Staff inspect the lunches to ensure the food provide contains the necessary essential food items and is void of junk food. LPA observed a menu posted in the CCC's kitchen area. LPA notes children have access to drinking water both inside the CCC and outside in the CCC. The Director was informed of recent mandates to lead test water prior to 1/1/23.

Disinfectants and cleaning solutions are secured in the kitchen cabinet underneath the sink. Medication in the CCC is secured in an elevated cabinet in the kitchen which is inaccessible to children in care. Sharps in the CCC are kept in kitchen area in an elevated cabinet which is inaccessible and beyond the reach children in care.

The CCC's outdoor play area is enclosed by wooden fencing and the footing is made up of wood chips on the ground. The fence's entry/exit gates are secured. LPA observed age appropriate toys and play equipment in the play area. The toys and play equipment are in suitable condition and free of sharp, loose or pointed objects.The Director was reminded to change equipment and toys once they begin to degrade. The play structures in the play areas have adequate cushioning materials to absorb falls and shade in the area is created by building over hangs. No bodies of water are located on site.

(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: 05/31/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/31/2022

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: CHILD'S SMILE PRESCHOOL	FACILITY NUMBER: 401711246
	VISIT DATE: 05/31/2022

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LPA observed required notices and documents posted on the wall of the CCC in the kitchen area. LPA reviewed Sign In/Out forms upon arrival at the CCC and found documentation to be completed appropriately.
LPA reviewed staff and children's records. The children’s records were complete and found to contain emergency contact information as well as immunization records. Staff records were reviewed. LPA found current CPR/ First Aid (EMSA) and Mandated Reporter Training Certifications. Director was reminded to renew the required training certifications prior to expiration. Director informed LPA no firearm or ammunition are stored on the site.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing 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

Administrator was reminded that all adults 18 and over working in the CCC, 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 licensed 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 Director Laura Karlyn-Viger.

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Elvin Baddley	TELEPHONE: (805) 635-4697
LICENSING EVALUATOR SIGNATURE:	DATE: 05/31/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/31/2022

LIC809 (FAS) - (06/04)

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