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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 406210901
Report Date: 09/27/2019
Date Signed: 09/27/2019 11:32:22 AM

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:PASO ROBLES CO-OPERATIVE PRESCHOOL, INCFACILITY NUMBER:
406210901
ADMINISTRATOR:JOHNA DE BELLISFACILITY TYPE:
850
ADDRESS:533 15TH STREETTELEPHONE:
(805) 238-5059
CITY:PASO ROBLESSTATE: CAZIP CODE:
93446
CAPACITY:24CENSUS: 17DATE:
09/27/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
10:25 AM
MET WITH:Johna De BellisTIME COMPLETED:
11:35 AM
NARRATIVE
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(1) Licensing Program Analyst (LPA), Melissa Stewart, conducted an annual random inspection and met with Director, Johna De Bellis. The purpose of the inspection was explained and the center was toured inside and out. The preschool operates, Monday - Friday 8:30am -12:00 pm. The preschool consists of a Pre-K class and a Two-Four year old class. The Two - Four year old class was not in session on the day of inspection. There were 17 children present in the Pre-K classroom with one teacher and two parent helpers. LPA observed the sign in and out sheet which is located at the entrance to the center. All required forms are posted. Children bring their own snacks which are stored in lunch boxes in individual children's cubbies. The classrooms were observed to be clean, organized and free of toxins. LPA observed age appropriate toys, books, games, and furnishings. All hazardous items are stored inaccessible to children. The last fire/emergency disaster drill was conducted on 9/16/19. There are functioning carbon monoxide and smoke detectors in the center. Director reported that there are no firearms or ammunition on the premises. No bodies of water were observed. Medication is stored in the staff restroom which is inaccessible to children. The center has a first aid kit. The children's restroom was observed to clean and free of toxins.

The outdoor play area is completely fenced. LPA observed age appropriate toys, play structures with appropriate cushioning, shade area, bikes, bike area, grass area and tables. Drinking water is available both inside and outside.
Continued on 809-C
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Melissa K StewartTELEPHONE: (805) 689-6267
LICENSING EVALUATOR SIGNATURE:

DATE: 09/27/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2019
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: PASO ROBLES CO-OPERATIVE PRESCHOOL, INC
FACILITY NUMBER: 406210901
VISIT DATE: 09/27/2019
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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: www.ada.gov/childqanda.htm

A sample of staff files were reviewed. Director and teacher are current with CPR and First Aid and have completed the Mandated Reporter Training per AB 1207. Employed staff and parent volunteers have met immunization requirements per SB 792.



Sampling of children's records reviewed and found complete.

LPA reviewed and provided Licensee with a copy of “Child Care Providers Guide to Safe Sleep.” LPA provided “Effects of Lead Exposure” 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 areas evaluated, no deficiencies cited.

LPA observed Director 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: 09/27/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2019
LIC809 (FAS) - (06/04)
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