401712125-8-19-2021-17-CC-EBAY-C62UQL-20210819154718

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 401712125
Report Date: 08/19/2021
Date Signed: 08/19/2021 03:47:32 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:	SINSHEIMER SUN ' N FUN PROGRAM		FACILITY NUMBER:	401712125
ADMINISTRATOR:	MICHELLE ROLLE		FACILITY TYPE:	840
ADDRESS:	2755 AUGUSTA ST.		TELEPHONE:	(805) 540-8506
CITY:	SAN LUIS OBISPO	STATE: CA	ZIP CODE:	93401
CAPACITY:	66	CENSUS: 13	DATE:	08/19/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	02:25 PM
MET WITH:	Michelle Rolle		TIME COMPLETED:	03:45 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 8/19/21, at 2:25 PM, Licensing Program Analyst (LPA) Elvin Baddley conducted an unannounced Required Annual inspection of the abovementioned Child Care Center (CCC). LPA met with Michelle Rolle, 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 classroom on the grounds Sinsheimer Elementary School. The CCC operates from 7:00 AM to 6:00 PM, Monday thru Friday. LPA observed 13 children in care during the inspection along with two teacher (cleared and associated). The CCC classroom has age appropriate equipment and furnishings available to children in care. LPA observed a carbon monoxide detector in the CCC which was tested at 2:40 PM and found to be operable. The bathrooms used by the children ( in side the classroom and on the grounds of the elementary school) are in sanitary operating condition. LPA observed an operable refrigerator in the classroom room which contains food for the children. The CCC provides snacks for the children and LPA observed a CCC menu affixed to the refrigerator. Disinfectants and cleaning solutions are locked in an elevated cabinet in the classroom which is beyond the reach of children in care. Director informed LPA no medication is on site, however if medication were present, medications would also be secured in an elevated cabinet in the classroom. LPA reviewed the CCC Sign In/Out forms for children upon arrival and noted the forms are completed appropriately. LPA observed required licensing notices and documents posted on the wall near the entry of the CCC. The CCC's outdoor playground areas are enclosed by combination chain linked and wrought iron 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 area have adequate cushioning materials in the form of sand to absorb falls. No bodies of (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: 08/19/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2021

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: SINSHEIMER SUN ' N FUN PROGRAM	FACILITY NUMBER: 401712125
	VISIT DATE: 08/19/2021

NARRATIVE

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water are observed on site. There is available drinking water for children both inside the classroom and outside in the play area. LPA notes the outdoor play area is shared with two of the Elementary school's kindergarten classrooms. The Director informed LPA the CCC's children play in the play area at times different that the elementary school students.

A sampling of staff and children's records are reviewed. The children’s records are complete and found to contain emergency contact information. Staff records are reviewed and contained documentation to support their educational training and experience. LPA also observed current pediatric CPR and First Aid (EMSA approved) certifications along with Mandated Reporter training certifications. Director noted no firearm or ammunition is stored on site.

This CCC 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 guidance and best practices with the Director. Director is reminded that it is Director's responsibility to know the regulations for a CCC which can be accessed on-line at www.ccld.ca.gov.

In areas evaluated, there were no deficiencies cited at this time.

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: 08/19/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2021

LIC809 (FAS) - (06/04)

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