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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 406215890
Report Date: 09/17/2021
Date Signed: 09/17/2021 03:47:16 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:LEARNING TREE, THEFACILITY NUMBER:
406215890
ADMINISTRATOR:KELSEY SULLIVANFACILITY TYPE:
840
ADDRESS:2607 TRAFFIC WAYTELEPHONE:
(805) 466-1133
CITY:ATASCADEROSTATE: CAZIP CODE:
93422
CAPACITY:36CENSUS: 12DATE:
09/17/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:52 PM
MET WITH:Kelsey SullivanTIME COMPLETED:
03:55 PM
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On 9/17/2021 at 2:52pm, Licensing Program Analyst (LPA) Melissa Stewart conducted an unannounced, Required- 1 year inspection and met with Director, Kelsey Sullivan. LPA conducted a Risk Assessment for COVID19 and all answers indicated no exposure to COVID19. The school age center operates, Monday - Friday, 7:45am - 4:30pm. All required forms, including monthly menu, are posted in the reception area near Director's office. The center was toured inside and outside. The classroom and restrooms were observed to be clean, organized and free of toxins. LPA observed indoor activity centers containing toys, games, books, art and dramatic play areas, tables and chairs, couch and carpet area with TV and indoor mini basketball hoops. Director stated that children are encouraged to wear face coverings while indoors and has face coverings available for children at the entry hallway next to the children's cubbies for storing personal belongings.

There were 12 children supervised by two (2) staff in the school age outdoor activity which is completely fenced and separated from the preschool outdoor area. There are child sized tables located under a covered patio adn climbing equipment with wood chips to cushion a fall. On the asphalt there is a tether ball, basket ball hoop, mini soccer area with goals, playhouse, riding toys and various outdoor activity equipment. Equipment was in safe condition free of sharp loose or pointed parts. Drinking water is available both inside and outside via individual water bottles brought from home or disposable cups.

The center conducts monthly emergency and disaster drills. The most recent drill was held on 8/30/21. The first aid kit is stored in the children's restroom. LPA observed the combination smoke and carbon monoxide detector mounted in the school age room which was tested and found to be operational. Director reported that there are no firearms, ammunition or bodies of water on the premises. No detergents, cleaning compounds, medications and other items such as kitchen knives which could pose a danger to children were observed to be accessible to children.


Continued on 809-C
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Melissa K StewartTELEPHONE: (805) 689-6267
LICENSING EVALUATOR SIGNATURE:

DATE: 09/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 2
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: LEARNING TREE, THE
FACILITY NUMBER: 406215890
VISIT DATE: 09/17/2021
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At least one staff present today has current Pediatric CPR and First Aid certification expiring 3/10/2022. Staff have met immunization requirements per SB 792 and completed AB 1207 Mandated Reporter Training. LPA reminded Director that the Mandated Reporter training must be renewed every two (2) years. Center conducts monthly meetings which include on the job training in housekeeping and sanitation principles including universal precautions. All staff present today participated in the training held on 9/9/2021. Staff files reviewed for health screening. Child Care Facility Roster and a sample of children’s files were reviewed for medical assessment and ID and Emergency information.

Incidental Medical Services (IMS) policy was discussed. Director reported that that there are no children currently enrolled who require IMS. 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: www.ada.gov/childqanda.htm

Director reported that the “Effects of Lead Exposure” brochure is distributed to all families at time of enrollment. LPA advised that Community Care Licensing Division (CCLD) Provider Information Notices (PINs), Title 22, Division 12 regulations and California Department of Public Health COVID-19 guidelines for child care programs can be accessed on-line at www.cdss.ca.gov. COVID19 Information for San Luis Obispo County can be found at https://www.emergencyslo.org/en/covid19.aspx.

In all areas evaluated, no deficiencies cited.

A copy of this report and appeal rights were discussed and left with Kelsey Sullivan, whose signature on this form confirm receipt of these documents.

LPA provided a Notice of Site Visit (LIC 9213) to be posted. FAILURE TO POST THE NOTICE OF SITE VISIT FOR 30 DAYS MAY RESULT IN A $100.00 CIVIL PENALTY

SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Melissa K StewartTELEPHONE: (805) 689-6267
LICENSING EVALUATOR SIGNATURE:

DATE: 09/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2021
LIC809 (FAS) - (06/04)
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