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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 406212537
Report Date: 12/06/2022
Date Signed: 12/06/2022 04:04:21 PM


Document Has Been Signed on 12/06/2022 04:04 PM - 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:ST. PATRICK'S MERCY PRESCHOOLFACILITY NUMBER:
406212537
ADMINISTRATOR:MELISSA WARDFACILITY TYPE:
850
ADDRESS:900 W. BRANCH ST.TELEPHONE:
(805) 473-2517
CITY:ARROYO GRANDESTATE: CAZIP CODE:
93420
CAPACITY:45CENSUS: 23DATE:
12/06/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Melissa WardTIME COMPLETED:
04:15 PM
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On 12/6/22, at 1:30 PM, Licensing Program Analyst (LPA) Elvin Baddley conducted an unannounced One Year Required Inspection the abovementioned Child Care Center (CCC). The LPA met with Melissa Ward, Director of the CCC and explained the purpose of the inspection. The LPA, in the company of Director, toured the interior and exterior of the CCC. Assistance Director Lori Campos also participated in tour. The CCC operates on the grounds of St. Patrick's School from 7:30 AM to 5:00 PM, Monday - Friday. The CCC uses four classrooms for child care. LPA observed 23 children on site during the inspection along with four teachers (associated and cleared).

LPA observed Sign In/Out forms upon arrival at the CCC. The forms displayed the children's arrival and departure times in addition to the signature of authorized representatives. LPA reviewed posted licensing required notices, documents and forms near the CCC's entry.

The classrooms of the CCC are clean and organized. The classrooms have age appropriate toys and furnishings available for children as well as appropriate ventilation. The CCC has operable carbon monoxide detectors (2). At 3:30 PM, a carbon monoxide detector at the west end of the hallway tested and found to be operational. The restrooms in the CCC are is in safe and sanitary operating condition. LPA observed a refrigerator in CCC's kitchen which is operational and inaccessible to children in care. LPA notes snacks and lunches containing essential food groups are provided the by parents of children in care, while the CCC has available food items on site in the instant a parent fails to provide snacks or lunches for their child. Child in care have access to water provided by the CCC both inside and outside the facility.The Director was informed of the need to test the CCC's water sources for lead containments. Disinfectants and cleaning solutions are secured in the CCC's [janitorial] closet and kitchen cabinet underneath the sink. Additionally, these items are also located in elevated cabinet in each of the classroom which are inaccessible to children in care. LPA observed medication in the CCC stored in a kitchen cabinet which is also inaccessible to children in care. LPA observed sharps at the CCC on elevated cabinet shelves in each classroom. The aforementioned is

(CONT. LIC 809-C, Page 2)

SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Elvin BaddleyTELEPHONE: (805) 635-4697
LICENSING EVALUATOR SIGNATURE:
DATE: 12/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/06/2022
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: ST. PATRICK'S MERCY PRESCHOOL
FACILITY NUMBER: 406212537
VISIT DATE: 12/06/2022
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beyond the reach of children in care.

The CCC has an outdoor playground area with varied footing which is enclosed by wooden fencing. LPA observed age appropriate toys and play equipment in the play area. The toys and play equipment are in suitable condition and free of sharp, loose or pointed objects. The play structure in the playground area has adequate cushioning materials to absorb falls and an abundance of shade. No bodies of water were observed on site. Waste receptacles with tight fitting covers were observed throughout the CCC.

A sampling of staff and children records are reviewed. The children’s records are complete and found to contain emergency contact information as well as immunization records . Staff records are reviewed and contained current Pediatric CPR/First Aid and Mandated Reporter certifications . Director informed LPA no firearms or ammunition is stored on the premises.

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

Facility representative is 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 Facility Representative Lori Campos.
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Elvin BaddleyTELEPHONE: (805) 635-4697
LICENSING EVALUATOR SIGNATURE:

DATE: 12/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/06/2022
LIC809 (FAS) - (06/04)
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