406215289-1-29-2020-17-CC-EBAY-BLASPL-20200129130318

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 406215289
Report Date: 01/29/2020
Date Signed: 01/29/2020 01:03:25 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:	ADVENTURE KIDS		FACILITY NUMBER:	406215289
ADMINISTRATOR:	EVELYN CHOTO		FACILITY TYPE:	830
ADDRESS:	880 MANZANITA DR. RM. 7		TELEPHONE:	(805) 534-9446
CITY:	LOS OSOS	STATE: CA	ZIP CODE:	93402
CAPACITY:	16	CENSUS: 4	DATE:	01/29/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:45 AM
MET WITH:	Evelyn Choto		TIME COMPLETED:	10:45 AM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On January 29, 2020, at 9:45 AM, Licensing Program Analyst (LPAs) Elvin Baddley conducted an unannounced Annual/Random inspection of the abovementioned Child Care Center (CCC). LPAs met with Evelyn Choto, Director of the CCC and explained the purpose of the visit. LPA, in the company of the Director toured the interior and exterior of the CCC. Four children are present in the infant program at the time of the inspection. The CCC operates from 7:30 AM to 5:30 PM, Monday thru Friday. The CCC is a combined center with preschool and school aged programs. The infant program is located in classroom 7. Required licensing forms and documents are posted on the wall of the classroom. There are two staff supervising four infants. The classroom has age appropriate toys and furnishings as well as a changing table with a sink readily accessible. LPA observed four cribs available for infant use. The CCC uses mats for older infants that do not use the cribs. Food and milk is stored in a refrigerator located in the classroom. LPA reviewed a sampling of Individual Needs & Services plans. LPA also reviewed a sampling of feeding plans. Children bottles and food were properly labeled with the child's name and date. LPA did not observe any toxins/hazardous items accessible to children.Director informed the LPA the CCC does not have firearms or ammunition on site. Center uses written sign-in/sign-out sheets near the door of the classroom. A sampling of children and staff records were reviewed. Teachers have required qualifications. Teachers present have current First Aid/CPR certificates which expire on June 13, 2020. Teachers present have current AB 1207 Mandated Reporter Training certificates which expire on July 25, 2021. LPA verified SB 792 Child Care Adult Immunization and Tuberculosis Requirements. Director was provided a Guide for Safe Sleep and effects of Lead Exposure leaflets. Incidental Medical Services (IMS) policy was discussed. When any IMS is provided, an updated APPLY.CONT.809-C

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Elvin Baddley	TELEPHONE: (805) 635-4697
LICENSING EVALUATOR SIGNATURE:	DATE: 01/29/2020

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2020

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: ADVENTURE KIDS	FACILITY NUMBER: 406215289
	VISIT DATE: 01/29/2020

NARRATIVE

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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

No deficiencies were cited during today's visit.

THE NOTICE OF SITE VISIT WAS POSTED AS REQUIRED BY H&S CODE SEC. 1596.817. THE NOTICE OF SITE VISIT MUST REMAIN POSTED FOR 30 DAYS OR A CIVIL PENALTY OF $100.00 WILL

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Elvin Baddley	TELEPHONE: (805) 635-4697
LICENSING EVALUATOR SIGNATURE:	DATE: 01/29/2020

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2020

LIC809 (FAS) - (06/04)

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