401711736-6-18-2021-17-CC-EBAY-C44PXZ-20210618114311

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 401711736
Report Date: 06/18/2021
Date Signed: 06/18/2021 11:43:22 AM

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:	OCEANVIEW ELEMENTARY SCHOOL		FACILITY NUMBER:	401711736
ADMINISTRATOR:	CARRIE VAN BEVEREN		FACILITY TYPE:	840
ADDRESS:	1208 LINDA DRIVE		TELEPHONE:	(805) 473-5476
CITY:	ARROYO GRANDE	STATE: CA	ZIP CODE:	93420
CAPACITY:	84	CENSUS: 20	DATE:	06/18/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:46 AM
MET WITH:	Carrie Van Beveren		TIME COMPLETED:	11:46 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 6/18/21, at 9:46 AM, Licensing Program Analyst (LPA) Elvin Baddley conducted an unannounced Required inspection the abovementioned Child Care Center (CCC). LPAs met with Carrie Van Beveren, Administrator of the CCC and explained the nature and purpose of the inspection. LPA, in the company of Administrator toured the interior and exterior of the CCC. The center is a School Age program which use two classrooms (Clasroom E, Classroom F) and the cafeteria on the grounds of Oceanview Elementary school. At the time of the inspection the CCC has a population of 20 children in care. Four teachers, in addition to the Administrator are providing supervision of the children in care. The classrooms of the CCC are clean and organized. The classrooms have age appropriate furnishings and play equipment available for children. Each classroom has carbon monoxide detectors which were tested and found to be operable (9:20 AM and 10:15 AM). Disinfectants, cleaning supplies, medication and sharps are secured in cabinets in the CCC's classroom. Each classroom has an operable refrigerator and is free of hazardous items. The CCC provides snacks for the children and children are able to receive lunch provided by the CCC (through the school district) or bring their own lunches from home. The CCC provides the children in care individual bottle water. LPA reviewed observed menus, as well as licensing required notices posted predominately on the walls of the classroom near each entry/exit. The Sign In/Out forms for the CCC were observed on the entry ramps of the classroom. LPA notes the Sign In/Out forms were completed appropriately. Waste receptacles on site are observed to have tight fitting covers. The CCC use two outdoor playground areas which are enclosed by chain linked fencing. LPAs observed age appropriate play equipment in each . The play equipment is in suitable condition and free of sharp as well as loose or pointed objects. The play structures in the playground areas have adequate cushioning materials (i.e. sand) to absorb falls and shade created by trees covered areas. LPA observed no bodies of water 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: 06/18/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2021

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: OCEANVIEW ELEMENTARY SCHOOL	FACILITY NUMBER: 401711736
	VISIT DATE: 06/18/2021

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 found to be current. Administrator's records were also reviewed and found to be current. Administrator's CPR/First Aid expires 3/13/21, while the expiration of the Administrator's Mandated Reporter training is 9/18/21. The Administrator informed LPA 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

LPA discussed COVID-19 best practices and guidance with Administrator. Administrator was reminded of Administrator's responsibility to know the regulations for 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: Elvin Baddley	TELEPHONE: (805) 635-4697
LICENSING EVALUATOR SIGNATURE:	DATE: 06/18/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2021

LIC809 (FAS) - (06/04)

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