406200031-8-9-2021-17-CC-EBAY-C5QQEZ-20210809120711

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 406200031
Report Date: 08/09/2021
Date Signed: 08/09/2021 12:07:39 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:	GRANDMOTHER'S HOUSE AT ST. STEPHENS		FACILITY NUMBER:	406200031
ADMINISTRATOR:	DOTTIE RYAN		FACILITY TYPE:	850
ADDRESS:	1344 NIPOMO STREET		TELEPHONE:	(805) 541-1305
CITY:	SAN LUIS OBISPO	STATE: CA	ZIP CODE:	93401
CAPACITY:	23	CENSUS: 6	DATE:	08/09/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Dottie Ryan		TIME COMPLETED:	12:00 PM

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On 8/9/21, at 9:15 AM, Licensing Program Analyst (LPA) Elvin Baddley conducted an unannounced Required Inspection the abovementioned Child Care Center (CCC). The LPA met with Dottie Ryan, Director of the CCC and explained the purpose of the inspection. The LPA, in the company of Director, toured the interior and exterior of the CCC. The CCC operates from 8:30:AM to 12:45 PM, Monday - Friday. The aforementioned operating hours were adjusted from 8:30 AM to 3:00 PM, Monday - Friday, given the pandemic. The CCC uses four classrooms (Rainbow Room- ages 3-K, Sunshine Room - ages 3, Flower Room ages 2-3 and Storage Room-unoccupied) for child care. LPA observed 6 children on site during the inspection along with four teachers (associated and cleared).

The classrooms of the CCC are clean and organized. The classrooms had age appropriate toys and furnishings available for children as well as appropriate ventilation. The CCC has operable carbon monoxide detectors in each classroom. At 10:41 AM, a carbon monoxide detector was tested in the Sunshine Room and found to be operational. The restrooms in the CCC are is in safe and sanitary operating condition. LPA observed a mini refrigerator in the Director's office which is operational and inaccessible to children in care. Child in care have access to water provided by the CCC both inside and outside the facility. Disinfectants and cleaning solutions are secured on elevated cabinet shelves in each classroom which is inaccessible to children in care. Likewise, medication in the CCC is stored in a "medication box" which is locked and store on the shelf of a elevated cabinet in the Sunshine Room. LPA observed sharps at the CCC on elevated shelves in each room which are beyond the reach of children in care.

LPA reviewed a posted menu along with licensing required notices and documents posted predominately on a courtyard wall. LPA observed Sign In/Out forms near the same location which are completed appropriately.

The CCC's outdoor playground area is enclosed by chain linked fencing. The footing in the area is grass. The area also has a large sand box and well as a play structure with wood chips at the base. The
(CONT. 809)

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Elvin Baddley	TELEPHONE: (805) 635-4697
LICENSING EVALUATOR SIGNATURE:	DATE: 08/09/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2021

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: GRANDMOTHER'S HOUSE AT ST. STEPHENS	FACILITY NUMBER: 406200031
	VISIT DATE: 08/09/2021

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fence of the playground area is observed secure. The toys and play equipment are in suitable condition and free of sharp, loose or pointed objects. The play structure in the playground area has adequate cushioning materials to absorb falls (wood chips) and an abundance of shade is observed in the courtyard area where children in care also play. No bodies of water were observed on site. Waste receptacles with tight fitting covers were observed throughout the center.

A sampling of staff and children records are reviewed. The children’s records are complete and found to contain emergency contact information as well as medical assessments. Staff records are reviewed and contained current Pediatric CPR/First Aid and Mandated Reporter certifications . Director informed LPA no firearm or ammunition is stored on site.

This facility doe not 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. Specifically the topic of face covering was discussed in detail. 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: 08/09/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2021

LIC809 (FAS) - (06/04)

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