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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 406214085
Report Date: 11/01/2024
Date Signed: 11/01/2024 02:51:26 PM

Document Has Been Signed on 11/01/2024 02:51 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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:SHEPHERD'S CHRISTIAN PRESCHOOLFACILITY NUMBER:
406214085
ADMINISTRATOR/
DIRECTOR:
TERESA A. SHEPHERDFACILITY TYPE:
850
ADDRESS:4410 PORTOLA ROADTELEPHONE:
(805) 406-0798
CITY:ATASCADEROSTATE: CAZIP CODE:
93422
CAPACITY: 20TOTAL ENROLLED CHILDREN: 20CENSUS: 5DATE:
11/01/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:40 AM
MET WITH:Teresa ShepherdTIME VISIT/
INSPECTION COMPLETED:
01:59 PM
NARRATIVE
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On 11/1/24, at 12:40 PM, Licensing Program Analysts (LPAs) Shane Loftus and Elvin Baddley conducted an unannounced Annual/Random Inspection of the abovementioned Child Care Center (CCC). LPAs met with Teresa Shepherd, Director of the CCC and explained the purpose of the inspection. The LPAs, in the company of Director toured the interior and exterior of the CCC. The CCC operates from 7:30 AM to 5:15 PM, Monday - Friday. The CCC uses two classrooms (Toddler Room and Preschool Room) and the backyard for child care. LPAs note the CCC is a preschool program with a toddler option. LPAs observed 5 children on site along with 3 teachers (cleared and associated) providing care and supervision.

LPAs observed the classrooms of the CCC to be clean and organized. Each classroom has age-appropriate toys and furnishings available for children. Disinfectants, cleaning solutions, and sharps are stored in the CCC’s office which is inaccessible to children in care. LPA’s observed a dual carbon monoxide/smoke alarm which was not tested due to it being incorporated within the fire system. LPAs observed the CCC's restrooms, two in total, to be in safe and sanitary operating condition. The CCC has an operable refrigerator for food storage. Director informed LPAs children in care bring a morning snack and lunches from home. The CCC's has an additional food supply.

CCCs constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1- CCP). LPAs verified that the lead testing was not completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP. The CCC provides filtered bottled water to children in care when needed.

LPAs observed the required licensing documents and forms posted in the office of the CCC, which is located between the two classrooms.

Continued on 809-C
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Shane Loftus
LICENSING EVALUATOR SIGNATURE: DATE: 11/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/01/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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Document Has Been Signed on 11/01/2024 02:51 PM - It Cannot Be Edited


Created By: Shane Loftus On 11/01/2024 at 01:47 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: SHEPHERD'S CHRISTIAN PRESCHOOL

FACILITY NUMBER: 406214085

DEFICIENCY INFORMATION FOR THIS PAGE:

VISIT DATE: 11/01/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1597.16(a)(1)
Lead Testing
(1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and record review, the licensee did not comply with the section cited above in that lead testing has not been completed, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/15/2024
Plan of Correction
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Licensee will submit proof of lead testing results to CCLD (shane.loftus@dss.ca.gov) by 11/15/24.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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 Mueller
LICENSING EVALUATOR NAME:Shane Loftus
LICENSING EVALUATOR SIGNATURE:
DATE: 11/01/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/01/2024


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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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: SHEPHERD'S CHRISTIAN PRESCHOOL
FACILITY NUMBER: 406214085
VISIT DATE: 11/01/2024
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The CCC uses a physical sign in/sign out sheet. LPAs reviewed Sign In/Out information which notes the arrival and depart time of children, along with an entry from the children's authorized representatives/parents.

The CCC's outdoor activity area is comprised of a varied footing. The outdoor area is enclosed by wooden fencing. The fence’s entry/exit gates are secured. The LPAs observed age-appropriate toys/play equipment in the play area. The toys/play equipment are in suitable condition and free of sharp, loose or pointed objects. The play structures in the activity areas have adequate cushioning materials to absorb falls. LPAs reminded Director to replace outdoor toys and play equipment when such items begin to degrade or are not in good repair. LPAs observed the outdoor areas to have ample shade provided by tress and a gazebo. No bodies of water were observed on site.

LPAs reviewed staff and children's records The children’s records were complete and found to contain emergency contact information and immunization records, among other required licensing documents and forms. Staff member's records were reviewed and contained current CPR and First Aid certifications and well as Mandated Reporter certifications and qualifications, among other required licensing documents and forms. LPAs note CCC records indicate the last fire drill was completed in 10/1/24. Director informed LPAs no firearm or ammunition is stored on site.

This facility does not provide Incidental Medical Services (IMS). LPAs reviewed storage of “medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication. Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.



Director was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

To improve the quality and value of the new inspection process, a survey may be sent to the email address

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SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Shane Loftus
LICENSING EVALUATOR SIGNATURE:

DATE: 11/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/01/2024
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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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: SHEPHERD'S CHRISTIAN PRESCHOOL
FACILITY NUMBER: 406214085
VISIT DATE: 11/01/2024
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provided. Please complete the survey and share your inspection experience. If you have any questions
regarding the process or CARE tools, please send email inquiries 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/inspection-process.

Type B Deficiencies are being cited based on LPAs records review pursuant to Title 22 of the CA Code of Regulations and HSC. Licensee was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these rights.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Director Teresa Shepherd.

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Shane Loftus
LICENSING EVALUATOR SIGNATURE:

DATE: 11/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/01/2024
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