406208270-9-2-2021-17-CC-EBAY-C6GVLT-20210902163227

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 406208270
Report Date: 09/02/2021
Date Signed: 09/02/2021 04:32:36 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:	CAPSLO - SANTA ROSA EARLY EDUCATION & CHILD CARE		FACILITY NUMBER:	406208270
ADMINISTRATOR:	A. RAMIREZ-BARRON		FACILITY TYPE:	850
ADDRESS:	864 SANTA ROSA		TELEPHONE:	(805) 594-1752
CITY:	SAN LUIS OBISPO	STATE: CA	ZIP CODE:	93401
CAPACITY:	17	CENSUS: 6	DATE:	09/02/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	03:15 PM
MET WITH:	Maria Velazquez		TIME COMPLETED:	04:30 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 9/2/21, at 3:15 PM Licensing Program Analyst (LPA) Elvin Baddley conducted unannounced Required Inspection of abovementioned Child Care Center (CCC). LPA met with Maria Velazquez, Acting Site Supervisor of the CCC and explained the purpose of the inspection. LPA, in the company of the Supervisor toured the interior and exterior of the CCC. The CCC operates from 7:30 AM to 5:00 PM, Monday - Friday. The CCC had a population of six children in care at the time of the inspection along with two teachers providing supervision.. The classroom of the CCC was clean and organized. The classroom had age appropriate toys and furnishings available for children in care. The classroom had an operable carbon monoxide detector which was tested at 3:32 PM. The bathrooms of the CCC are observed in safe and sanitary operating condition. The attached kitchen was observed to be clean and free of litter. The CCC has a locked cabinet in the kitchen area for medication. Disinfectants and cleaning solutions are observed in the kitchen area which is inaccessible to children in care. The CCC provides breakfast, lunch and snacks to children in care. LPA observed a posted menu near the CCC's parent wall. There is available drinking water for children both inside the classroom and outside in the play area. Licensing required documentation is posted predominately in the classroom. Sign In/Out documentation for children was reviewed and found suitable. The CCC's outdoor play area is enclosed by chain linked and wooden fencing. The fence’s entry/exit gates are secured. The LPA observed age appropriate toys/play equipment in the play area. The toys/play equipment are in suitable condition and free of sharp, loose or pointed objects. The play structure in the playground areas has an adequate cushioning materials to absorb falls and an abundance of shade created by building overhangs and tress. LPA observed no bodies of water on site. Waste receptacles with tight fitting covers were observed throughout the CCC. (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: 09/02/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/02/2021

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: CAPSLO - SANTA ROSA EARLY EDUCATION & CHILD CARE	FACILITY NUMBER: 406208270
	VISIT DATE: 09/02/2021

NARRATIVE

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A sampling of staff and children's records were reviewed. The children’s records were complete and found to contain emergency consent information as well as immunizations. Staff records were reviewed and contained current Pediatric First Aid/CPR certifications (EMSA approved) and Mandated Reporter training certificates. Supervisor noted no firearm 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 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 Supervisor. Supervisor was reminded that it is Supervisor's responsibility to know the regulations for a CCC which can be accessed on-line at www.ccld.ca.gov.

In areas evaluated, no deficiencies observed.

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: 09/02/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/02/2021

LIC809 (FAS) - (06/04)

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