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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 406215080
Report Date: 09/22/2022
Date Signed: 09/22/2022 04:45:15 PM


Document Has Been Signed on 09/22/2022 04:45 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:WISHING WELL SCHOOL OF THE CENTRAL COASTFACILITY NUMBER:
406215080
ADMINISTRATOR:KIM WISHONFACILITY TYPE:
840
ADDRESS:880 MANZANITATELEPHONE:
(805) 235-4401
CITY:LOS OSOSSTATE: CAZIP CODE:
93402
CAPACITY:21CENSUS: 28DATE:
09/22/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:25 PM
MET WITH:Hillary Soldati and Kyra Smith TIME COMPLETED:
04:00 PM
NARRATIVE
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On 9/22/2022 at 12:25 PM Licensing Program Analyst (LPA) Gigi Reyes conducted an unannounced Required inspection the above mentioned Child Care Center (CCC). LPA met with Hilary Soldati Administrative Director of the Wishing Well School and Kyra Smith, Lead Teacher. LPA explained the nature and purpose of the inspection. LPA in the company of Ms. Soldati toured the interior and exterior of the CCC. This is a school age program using the Classroom no. 15. There were 28 children and 3 staff present at the time of the inspection. The CCC is operating beyond its capacity limit of 21, capacity limitation deficiency was cited under Case Management.

The classroom of the CCC is clean and organized. The classroom has age appropriate furnishings available for children. The classroom has an operable carbon monoxide detector. The restroom used by children are in safe and sanitary operating condition located in the Wishing Well school grounds.
LPA viewed the Sign In/Out forms for the CCC LPA observed the forms contained the children's arrivals and exits times along with signatures of the children's authorized representative.

The CCC's outdoor playground area is fenced with age appropriate play equipment. No bodies of water were observed on site. There is available drinking water for children both inside and outside of the classroom. Ms. Soldati was reminded to ensure the CCC's water sources are tested for lead containment.

A sampling of staff and children records were reviewed. The children’s records contain emergency contact information. Staff present has a Pediatric First Aid/CPR expires on 8/31/2024. During file review, it was observed that Staff Steven Farmers (started on 9/7/2022) , and Mckena Barkhuff (started 9/22/2022) who were assisting in the school age program have no Criminal Record Clearance on file. Both staff have no immunization record, no Health Screening Report including tuberculosis (LIC 503) Staff 2 have not taken AB 1207 or Mandated Reporter Training
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi ReyesTELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:
DATE: 09/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/22/2022
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: WISHING WELL SCHOOL OF THE CENTRAL COAST
FACILITY NUMBER: 406215080
VISIT DATE: 09/22/2022
NARRATIVE
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During today's inspection, Type A and Type B deficiencies were cited under Title 22 Division 12. and Health and Safety Code. A Civil Penalty of $ 600.00 was assessed.

LPA Reyes informed Ms. Hilary Soldati that this report dated 9/22/2022 documents one Type A citation which shall be posted for 30 consecutive days as there are immediate risks to the health, safety, or personal rights of children in care.
Also, LPA Reyes informed the Ms. Soldati to provide a copy of this licensing report dated 9/22/2022 that documents any Type A citations to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

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.Document Link Icon

Ms. Soldati 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 Administrative Director, Ms Hilary Soldati
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi ReyesTELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:

DATE: 09/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2022
LIC809 (FAS) - (06/04)
Page: 2 of 5
Document Has Been Signed on 09/22/2022 04:45 PM - It Cannot Be Edited

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: WISHING WELL SCHOOL OF THE CENTRAL COAST

FACILITY NUMBER: 406215080

DEFICIENCY INFORMATION FOR THIS PAGE:

VISIT DATE: 09/22/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
101170(e)(1)
Criminal Record Clearance
(e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility: (1) Obtain a California clearance or a criminal record exemption as required by the Department or

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review and interview, the licensee did not comply with the section cited above , Staff Steven Farmers who started on 9/7/2022 and Mckena Barkhuff who started assisting on 9/22/2022 do not have a criminal record clearance and were observed assisting in the supervision of school age children.
POC Due Date: 09/23/2022
Plan of Correction
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Ms. Soldati Agreed that the 2 staff will obtain Criminal Record Clearance the next business day, 9/23/2022. POC statement will be submitted to CCL no later than 9/23/2022.
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 MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi ReyesTELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:
DATE: 09/22/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/22/2022
LIC809 (FAS) - (06/04)
Page: 3 of 5


Document Has Been Signed on 09/22/2022 04:45 PM - It Cannot Be Edited

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: WISHING WELL SCHOOL OF THE CENTRAL COAST

FACILITY NUMBER: 406215080

DEFICIENCY INFORMATION FOR THIS PAGE:

VISIT DATE: 09/22/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101174(d)(2)
Disaster and Mass Casualty Plan
(d) Disaster drills shall be conducted at least every six months. (2) The drills shall be documented. This documentation shall be kept in the child care center for at least one year.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, did not comply with the section cited above, Ms. Soldati stated drill was conducted but not documented which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/03/2022
Plan of Correction
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Ms. Soldati agreed to submit the Plan of Correction to CCL no later than 10/10/2022 on how to ensure that fire and disaster drill conducted every 6 months will be documented.
Type B
Section Cited
HSC
1596.7995(a)(1)
General Provisions and Definitions
(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above Staff 2 and Staff 3 do not have record of immunization on file which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/10/2022
Plan of Correction
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Ms. Soldati agreed to submit the Plan of Correction no later than 10/10/2022, a proof of correction shall likewise be submitted to CCL

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 MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi ReyesTELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:
DATE: 09/22/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/22/2022
LIC809 (FAS) - (06/04)
Page: 4 of 5


Document Has Been Signed on 09/22/2022 04:45 PM - It Cannot Be Edited

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: WISHING WELL SCHOOL OF THE CENTRAL COAST

FACILITY NUMBER: 406215080

DEFICIENCY INFORMATION FOR THIS PAGE:

VISIT DATE: 09/22/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review the licensee did not comply with the section cited above in Staff 2 did not take the Mandated Reproter Training, (AB 1207) which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/10/2022
Plan of Correction
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Ms. Soldati agreed to submit the Plan of Correction to CCL no later than 10/10/2022 and proof shall like wise be submitted.
Type B
Section Cited
CCR
101216(g)(1)
Personnel Requirements
(1) Except as specified in (3) below, good physical health shall be verified by a health screening, including a test for tuberculosis, performed by or under the supervision of a physician not more than one year prior to or seven days after employment or licensure.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above, Staff 2 and Staff 3 do not have an LIC 503 on file, Physical Health screening including the Tuberculosis test which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/10/2022
Plan of Correction
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Licensee agreed to submit the Plan of Correction to CCL no later than 10/10/2022 .

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 MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi ReyesTELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:
DATE: 09/22/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/22/2022
LIC809 (FAS) - (06/04)
Page: 5 of 5