406215833-6-15-2021-17-CC-EBAY-C3ZTPC-20210615145407

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 406215833
Report Date: 06/15/2021
Date Signed: 06/15/2021 02:54:13 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:	VILLAGE PRESCHOOL		FACILITY NUMBER:	406215833
ADMINISTRATOR:	KAMBER DOUCETTE		FACILITY TYPE:	850
ADDRESS:	205 SHORT STREET		TELEPHONE:	(805) 704-1302
CITY:	ARROYO GRANDE	STATE: CA	ZIP CODE:	93420
CAPACITY:	30	CENSUS: 17	DATE:	06/15/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Kamber Doucette		TIME COMPLETED:	03:00 PM

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 6/15/21, Licensing Program Analyst (LPA) Elvin Baddley conducted an unannounced Required inspection of the abovementioned Child Care Center (CCC). The LPA met with Kamber Doucette, Director of the CCC and explained the purpose of the inspection. LPA toured the interior and exterior of the CCC. The center operates from 7:00 AM to 5:30 PM, Monday - Friday. The CCC is a dedicated preschool program.. The CCC uses five classrooms for care and has a population of 17 children in care at the time of the inspection. The Director and a teacher were on site to provide supervision for children in care. The classrooms ( Play Room #1, Play Room #2. Pre K Room, Early Years Room and the MUD Room) of the CCC were clean and organized. The classrooms have age appropriate toys and furnishings available for children. The CCC has carbon monoxide detectors affixed to the classroom's walls which were tested (2:41 PM) and found to be operational. The CCC bathrooms are in safe and sanitary operating condition. The CCC bathroom contains two toilets and two sinks. Disinfectants and cleaning solutions in the CCC are stored in the staff restroom which is inaccessible to children in care. The Director noted the CCC currently has no medication on site. The Director stated when medication is on site the medication is stored in a room commonly referred to as the "shed" which is secure and inaccessible to children in care. The CCC provides snacks for the children. Children in care bring lunches from their homes. A CCC's menu is posted on a classroom wall near licensing required notices. LPA reviewed the CCC's Sign In/Out documentation which is processed electronically. The CCC’s outdoor playground, which is enclosed by wooden fencing, is comprised of artificial grass, concrete sidewalks and play structured areas. LPA observed age appropriate toys/play equipment in the play area. The toys/play equipment are free of sharp, loose or pointed objects. The play structures in the playground areas have adequate cushioning materials to absorb falls and an abundance of shade created by large trees and a tented area. No bodies of water are observed on site. There is available (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: 06/15/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/15/2021

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: VILLAGE PRESCHOOL	FACILITY NUMBER: 406215833
	VISIT DATE: 06/15/2021

NARRATIVE

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drinking water for children both inside the classroom and outside in the play area. Waste receptacles with tight fitting covers were observed throughout the center.

A sampling of staff and children records were reviewed. The children’s records were complete and found to contain emergency contact information. Staff records were reviewed and contained documentation to support their educational training and experience. The Director's CPR/First Aid Training was completed on 10/12/22, while the Director's Mandated Reporter Training was completed on present (6/15/21).

Director noted no firearms/weapons or ammunition are stored on the premises.

This facility provides Incidental Medical Services (IMS). For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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

LPA discussed COVID 19 guidance and best practices with the Director. Director was reminded that it is Director's responsibility to know the regulations for CCC which can be accessed on-line at www.ccld.ca.gov.

In areas evaluated, no deficiencies observed.
LPA observed Director post the Notice of Site visit (LIC 9213).

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Elvin Baddley	TELEPHONE: (805) 635-4697
LICENSING EVALUATOR SIGNATURE:	DATE: 06/15/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/15/2021

LIC809 (FAS) - (06/04)

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