406208150-5-26-2022-17-CC-FPEA-CESUJ2-20220526153649

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 406208150
Report Date: 05/26/2022
Date Signed: 05/26/2022 03:36:54 PM

Document Has Been Signed on 05/26/2022 03:36 PM - It Cannot Be Edited

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 CLUBHOUSE, THE		FACILITY NUMBER:	406208150
ADMINISTRATOR:	JEANNE HUNT		FACILITY TYPE:	840
ADDRESS:	714 CROCKER ST.		TELEPHONE:	(805) 434-1188
CITY:	TEMPLETON	STATE: CA	ZIP CODE:	93465
CAPACITY:	15	CENSUS: 15	DATE:	05/26/2022
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	01:31 PM
MET WITH:	Mercedes Petway		TIME COMPLETED:	03:51 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 May 26, 2022 at 1:31 PM, Licensing Program Analyst (LPA) Francisco Pedroza conducted an unannounced Annual/Random inspection. LPA met with facility Director Mercedes Petway and advised her the purpose of the inspection. Director Provided LPA a tour of the facility inside and out. The center operates from 7:00 AM to 5:30 PM, Monday thru Friday. There were 15 children in care at the time of the inspection. LPA observed licensing required documents posted prominently on the wall at the entrance of the facility. The facility is using one (1) classroom for children in care. LPA observed enough restrooms for children in care. Children hang their belongings on hook outside of the classroom. LPA observed age appropriate toys, activities, books, and furniture readily accessible for children to use. The center provides one stack for children during the afternoon while in care. The outdoor playground has an ample amount of space and shade for children to play. LPA observed the playground has age appropriate toys and structures available for children to use. The facility has water available for children inside and out. Children use their own personal water bottles from home if they have them. LPA observed the sign-in/sign-out sheet current. A sampling of children and staff records were reviewed. LPA observed children's files to be complete and current. Currently the facility does not have children that require Incident Medical services (IMS). LPA observed staff files to be complete and current. LPA verified SB792 Child Care Adult Immunization and Tuberculosis requirements. Teachers meet the required qualifications. Teacher are current on their Mandated Reporter training and the facility meets the CPR/First-Aid requirements. LPA spoke with Director about new Covid-19 guidelines. Facility is currently following Covid-19 guidelines. No deficiencies were cited during today's inspection. Continued on 809-C

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisco Pedroza	TELEPHONE: (805) 689-6267
LICENSING EVALUATOR SIGNATURE:	DATE: 05/26/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/26/2022

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 CLUBHOUSE, THE	FACILITY NUMBER: 406208150
	VISIT DATE: 05/26/2022

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
26
27
28
29
30
31
32

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

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

Director was reminded that all adults 18 and over, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Director

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisco Pedroza	TELEPHONE: (805) 689-6267
LICENSING EVALUATOR SIGNATURE:	DATE: 05/26/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/26/2022

LIC809 (FAS) - (06/04)

Page: 2 of 2