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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 406209096
Report Date: 02/18/2020
Date Signed: 02/20/2020 09:42:08 AM

COMPREHENSIVE INSPECTION
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:S.T.A.R.S.FACILITY NUMBER:
406209096
ADMINISTRATOR:ELLA PORTERFACILITY TYPE:
830
ADDRESS:1402 GOLDEN HILL RD.TELEPHONE:
(805) 238-0200
CITY:PASO ROBLESSTATE: CAZIP CODE:
93446
CAPACITY:25CENSUS: 16DATE:
02/18/2020
TYPE OF VISIT:Annual/RequiredUNANNOUNCEDTIME BEGAN:
01:40 PM
MET WITH:Cheryl RobertsTIME COMPLETED:
03:20 PM
NARRATIVE
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Licensing Program Analyst (LPA) Gigi Reyes conducted an unannounced Annual/Required inspection and met with Director Cheryl Roberts. There were 16 infants, 3 fully qualified teachers and 2 teacher aides present during the inspection. Infant Program uses 3 classrooms. LPA toured the Center inside and outside.
LPA observed age appropriate toys, equipment in the infant classrooms. Playground is enclosed with appropriate fence with age and size appropriate play structure and equipment. Director stated there are no guns nor ammunition in the center. There were nobodies of water observed.

There is a presence of carbon monoxide detector in each room. The infant rooms were observed to be clean and sanitary. Infant's changing tables are placed within arms reach. LPA randomly reviewed children's files and found complete. LPA reviewed the Needs and Services and were up to date. LPA reviewed teachers files, Staff # 1 does not have immunization record on file, and Staff # 1 has not taken the AB 1207 Mandated Reporter Training. Sign In/Sign out was reviewed and matched the no. of children present. LPA discussed the Safe Sleep Best Practices, recalled equipment and provided pertinent flyers.

Continued on 809 C
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi ReyesTELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:

DATE: 02/18/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/18/2020
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 3
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: S.T.A.R.S.
FACILITY NUMBER: 406209096
VISIT DATE: 02/18/2020
NARRATIVE
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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 Child Care Centers Sections 101173 and 101226.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

In the areas evaluated, deficiency was cited under Health and Safety Code in the attached 809 D. Appeal Rights was given to Director.

LPA observed Director posted the Notice of Site Visit.

SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi ReyesTELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:

DATE: 02/18/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/18/2020
LIC809 (FAS) - (06/04)
Page: 2 of 3
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: S.T.A.R.S.
FACILITY NUMBER: 406209096
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/18/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/28/2020
Section Cited

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a) (1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.
This requirement is not met as evidenced by:
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Based on LPA's review of record, it was observed that Staff # 1 does not have immunization record on file. Director stated Staff # 1 has it but has not submitted. This poses a potential risk to health and safety of children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi ReyesTELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:
DATE: 02/18/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/18/2020
LIC809 (FAS) - (06/04)
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