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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 406212309
Report Date: 10/10/2019
Date Signed: 10/10/2019 10:23:34 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:MORRO BAY UNITED METHODIST CHILDREN'S CENTERFACILITY NUMBER:
406212309
ADMINISTRATOR:CHRISTY HILLIARDFACILITY TYPE:
840
ADDRESS:3000 HEMLOCKTELEPHONE:
(805) 772-7897
CITY:MORRO BAYSTATE: CAZIP CODE:
93442
CAPACITY:30CENSUS: 0DATE:
10/10/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:50 PM
MET WITH:Christy HilliardTIME COMPLETED:
01:35 PM
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Licensing Program Analysts (LPAs) Gigi Reyes and Eric Lin made an unannounced visit to conduct a Confirmation of Removal (COR) for Megan Youngs. LPAs met with Administrator, Ms. Christy Hiiliard and explained the purpose of the inspection. LPAs toured the Center. No school age children were present during the time of visit.

LPAs interview with the Administrator revealed that Exemption Denial letter was received on October 7, 2019 and that LIC 300B Removal Confirmation Denial was mailed to CCLD office on the same day. Ms. Youngs’ employment was terminated on October 8, 2019. Ms. Hilliard handed a copy of LIC 300 B to LPAs during the inspection.

Based on the evidence obtained during today’s visit, LPAs have verified Ms. Megan Youngs is not present, nor employed in the facility. LPAs advised the Director to disassociate the individual from their roster. An updated LIC 500 Personnel Report was given to LPAs.

Verification of removal is complete. No deficiencies cited.

The "Notice of Site Visit" was observed posted.

FAILURE TO POST THE NOTICE OF SITE VISIT FOR 30 DAYS MAY RESULT IN A $100.00 CIVIL PENALTY.
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi ReyesTELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:

DATE: 10/10/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2019
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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