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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 406200031
Report Date: 06/26/2025
Date Signed: 06/26/2025 10:35:44 AM

Document Has Been Signed on 06/26/2025 10:35 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:GRANDMOTHER'S HOUSE AT ST. STEPHENSFACILITY NUMBER:
406200031
ADMINISTRATOR/
DIRECTOR:
DOTTIE RYANFACILITY TYPE:
850
ADDRESS:1344 NIPOMO STREETTELEPHONE:
(805) 541-1305
CITY:SAN LUIS OBISPOSTATE: CAZIP CODE:
93401
CAPACITY: 23TOTAL ENROLLED CHILDREN: 23CENSUS: 16DATE:
06/26/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:30 AM
MET WITH:Dottie RyanTIME VISIT/
INSPECTION COMPLETED:
10:50 AM
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On 06/26/2025, at 8:30 AM, Licensing Program Analyst (LPA) Shane Loftus conducted an unannounced Annual/Random Inspection the above-mentioned Child Care Center (CCC). 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 8:00 AM to 3:00 PM- Monday & Wednesday, 8:00 AM – 12:45 PM Tuesday & Thursday, and closed on Fridays. The CCC uses three classrooms (Classroom 1 - Toddlers; Classroom 2- four year olds, and Classroom 3 - three year olds) for child care. LPA observed 16 children on site during the inspection along with three teachers (associated and cleared). LPA notes the Director assists with the care and supervision of children at the CCC.

The classrooms of the CCC are clean and organized. The classrooms have age-appropriate toys and furnishings available for children as well as appropriate ventilation. CCC has a carbon monoxide detector in classroom 3 that was tested at 8:48 AM and found to be operable. The restroom in the CCC is in safe and sanitary operating condition. Disinfectants, cleaning solutions, and sharps are secured on elevated cabinet shelves in each classroom. Additionally, medication in the CCC is stored in a "medication box" which is locked and stored on the shelf of an elevated cabinet in Classroom 2. LPA notes all areas are inaccessible to children in care.

LPA reviewed licensing required notices and documents posted prominently in classroom 2 of the CCC. The CCC utilizes the BrightWheel application for Sign In/Out purposes. Continued on 809-C

Maria MuellerTELEPHONE: (805) 562-0400
Shane LoftusTELEPHONE: (805) 562-0400
DATE: 06/26/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/26/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: GRANDMOTHER'S HOUSE AT ST. STEPHENS
FACILITY NUMBER: 406200031
VISIT DATE: 06/26/2025
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LPA reviewed a sampling of children from the system which contains both arrival and departure times as well as the electronic signature of parents of children in care. Children in care have access to filtered water provided by the CCC both inside and outside the facility.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1- CCP). LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

The CCC's outdoor areas are enclosed by fencing. The fence gates of the outdoor areas are observed to be secure. The outdoor area is separated into an outdoor classroom area and a play area. The footing in the areas is varied. The outdoor play area has a large sand box and well as a play structure with adequate cushioning material in the form of wood chips to absorb falls. There is an abundance of shade to afford for the children’s comfort. The toys and play equipment are in suitable condition and free of sharp, loose or pointed objects. No bodies of water were observed on site. Waste receptacles with tight fitting covers were observed throughout the CCC.

LPA reviewed staff and children’s records. The children’s records are complete and found to contain emergency contact information as well as immunization records, among other required licensing documents. Staff records are reviewed and contained current Pediatric CPR/First Aid and Mandated Reporter certifications. Director informed LPA no firearms or ammunition is stored on 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 PIN 22-02-CCP. Continued on 809-C

SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0400
LICENSING EVALUATOR NAME: Shane LoftusTELEPHONE: (805) 562-0400
LICENSING EVALUATOR SIGNATURE:

DATE: 06/26/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2025
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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: GRANDMOTHER'S HOUSE AT ST. STEPHENS
FACILITY NUMBER: 406200031
VISIT DATE: 06/26/2025
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The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication. Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-carecenters/.

LPA discussed the safe sleep regulations with facility representative and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed facility representative of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Facility representative was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Facility representative was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

No deficiencies cited during todays inspection. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Facility representative Dottie Ryan.

SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0400
LICENSING EVALUATOR NAME: Shane LoftusTELEPHONE: (805) 562-0400
LICENSING EVALUATOR SIGNATURE:

DATE: 06/26/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2025
LIC809 (FAS) - (06/04)
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