406210226-6-7-2022-17-CC-GRES-CF6PRV-20220607113323

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 406210226
Report Date: 06/07/2022
Date Signed: 06/07/2022 11:33:30 AM

Document Has Been Signed on 06/07/2022 11:33 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
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME:	NIPOMO EARLY LEARNING CENTER		FACILITY NUMBER:	406210226
ADMINISTRATOR:	LAUREN THORNE - T5		FACILITY TYPE:	850
ADDRESS:	525 NORTH THOMPSON AVE		TELEPHONE:	(805) 929-1114
CITY:	NIPOMO	STATE: CA	ZIP CODE:	93444
CAPACITY:	30	CENSUS: 16	DATE:	06/07/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Melanie Powers		TIME COMPLETED:	11:40 AM

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 June 7, 2022 at 9:15 AM, Licensing Program Analyst (LPA) Gigi Reyes conducted an unannounced 1 Year Required Inspection met with Site Supervisor Melanie Powers and Teacher Carolyn Case. LPA explained the purpose of the inspection. Prior to inspection LPA asked screening questions related to COVID -19 and responses indicate there are no COVID-19 exposure on site. The Child Care Center (CCC) is located in the campus of Nipomo High School. The CCC operates Monday to Friday 9:00 AM to 12:00 PM, it operates in accordance with Lucia Mar School District schedule. LPA in the company of Ms. Powers toured the Center inside and out. There were 16 day care children and 2 staff present. Licensing required forms are posted in the wall. The current snack menu is also posted. The CCC provides snacks to day care children. The outdoor playground is enclosed with the wire fences, It has age appropriate toys and equipment. The playground has an ample amount cushioning. The center has drinking water available for children inside and out. Center uses individual sign-in/out sheet for each child.. A sampling of children and staff records were reviewed. Ms. Powers has valid Child Development Program Director Permit, Ms. Case has a valid Child Development Teacher Permit on file. Teachers present have current Pediatric First Aid/CPR certificates that expire on 8/18/2023. Facility is following current Covid-19 guidelines. LPA verified SB 792 Child Care Adult Immunization record and tuberculosis requirements. Continued on LIC 809C

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi Reyes	TELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:	DATE: 06/07/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2022

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: NIPOMO EARLY LEARNING CENTER	FACILITY NUMBER: 406210226
	VISIT DATE: 06/07/2022

NARRATIVE

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No deficiencies were cited during today's visit.

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.

Site Supervisor 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 Site Supervisor, Melanie Powers.

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi Reyes	TELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:	DATE: 06/07/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2022

LIC809 (FAS) - (06/04)

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