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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 406205649
Report Date: 11/20/2019
Date Signed: 11/20/2019 04:30:18 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:CHILDREN'S GARDEN, THEFACILITY NUMBER:
406205649
ADMINISTRATOR:MELINDA STALEYFACILITY TYPE:
840
ADDRESS:701 CROCKER ST.TELEPHONE:
(805) 434-1188
CITY:TEMPLETONSTATE: CAZIP CODE:
93465
CAPACITY:30CENSUS: 32DATE:
11/20/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Gina GoetschTIME COMPLETED:
04:30 PM
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(1) Licensing Program Analyst (LPA) Melissa Stewart conducted an annual random inspection and met with Director, Gina Goetsch. The purpose of the inspection was explained and the center was toured inside and out. The school age center operates in the Downstairs classroom from 6:30am - 6:00pm. At time of inspection, there were 12 kindergarteners supervised by one teacher in the classroom while 2 teachers were supervising 20 children at the park due to minimum day at the elementary school. All required forms, including menu, are posted. The classroom and children's restroom was observed to be clean and free of toxins. Medications are stored in a locked box in the Upstairs classroom. First aid kit is located by the sign in and out sheet. LPA observed age appropriate toys, games, tables, chairs, art supplies and activity centers. There is a functioning carbon monoxide detector that meets statutory requirements. The outdoor activity area is completely fenced and is equipped with age appropriate play structure, toys, shade area, sand box, garden, and picnic tables. There is also shed with additional toys, first aid kit and emergency supplies.

Director and at least one teacher are American Red Cross Adult/Infant CPR and First Aid certified through 6/7/21. A sampling of staff files were reviewed for AB1207 Mandated Reporter Training, health screening and immunization requirement per SB 792. A sample of children's files were reviewed for medical assessments and contact information regarding child's authorized representative and person's designated to assume responsibility should the authorized representative not be reached.
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Melissa K StewartTELEPHONE: (805) 689-6267
LICENSING EVALUATOR SIGNATURE:

DATE: 11/20/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/20/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 2
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: CHILDREN'S GARDEN, THE
FACILITY NUMBER: 406205649
VISIT DATE: 11/20/2019
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Center is not providing Incidental Medical Services. Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes 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

LPA provided “Effects of Lead Exposure” brochure to be distributed to all families. Director was advised to review Quarterly Updates and Provider Information Notices (PINs) which can be accessed on-line at www.ccld.ca.gov.



In the areas evaluated, no deficiency cited.

LPA observed Licensee post the Notice of Site visit.
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Melissa K StewartTELEPHONE: (805) 689-6267
LICENSING EVALUATOR SIGNATURE:

DATE: 11/20/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/20/2019
LIC809 (FAS) - (06/04)
Page: 2 of 2