421702975-2-18-2020-17-CC-EBAY-BLWSD3-20200218124629

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 421702975
Report Date: 02/18/2020
Date Signed: 02/18/2020 12:46:35 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:	SANTA MARIA VALLEY YMCA		FACILITY NUMBER:	421702975
ADMINISTRATOR:	KELSEY FERGUSON		FACILITY TYPE:	850
ADDRESS:	3400 SKYWAY DRIVE		TELEPHONE:	(805) 937-8521
CITY:	SANTA MARIA	STATE: CA	ZIP CODE:	93455
CAPACITY:	34	CENSUS: 23	DATE:	02/18/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	10:40 AM
MET WITH:	Kelsey Ferguson		TIME COMPLETED:	12:00 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 February 18, 2020, at 10:40 AM, Licensing Program Analyst (LPA) Elvin Baddley conducted an unannounced Annual/Random inspection the abovementioned Child Care Center (CCC). LPA met with Kelsey Ferguson, Director of the CCC and explained the purpose of the inspection. LPA, in the company of the Director toured the interior and exterior of the CCC. The center operates from 7:00 AM to 6:00 PM, Monday - Friday. The CCC uses one classroom for child care and had a population of 23 at the time of the inspection. The CCC's classroom was clean and organized. LPA observed age appropriate toys and furnishings available for children in the classroom. The classroom had a carbon monoxide detector which was found to be operable. LPA observed two restrooms which are in safe and sanitary operating condition. The restrooms had a total of six toilets, two urinals and four sinks. Disinfectants and cleaning solutions are locked in a classroom cabinet which is inaccessible to children. The CCC is not administering medication at this time but does have a locked medicine box/container in the classroom. The CCC provides snacks for the children and children bring lunches prepared from home. LPA reviewed a snack menu along with required licensing forms and documents posted on a board outside of the classroom. The CCC Sign In/Out binder was also review and found to be appropriate. The CCC's outdoor play area is enclosed by wooden fencing. The fence’s entry/exit gates are secured. The play area is comprised of grass lawns, concrete sidewalks and sand/wood chip play areas. LPA observed age appropriate toys/play equipment in the play areas. The toys/play equipment are in suitable condition and free of sharp, loose or pointed objects. The play structures in the play areas have adequate cushioning materials (i.e. wood chips and sand) to absorb falls. The play area also has an abundance of shade provided by covers and the buildings overhang. No bodies of water were observed on site. There is available drinking water for children both inside the classroom and outside in the play area. Waste receptacles with tight fitting 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: 02/18/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/18/2020

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: SANTA MARIA VALLEY YMCA	FACILITY NUMBER: 421702975
	VISIT DATE: 02/18/2020

NARRATIVE

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covers were observed throughout the center. Director informed LPA no firearms or ammunition is stored on the premises.

A sampling of staff and children records were reviewed. The children’s records were complete and found to contain emergency contact information as well as medical assessments. Staff records were reviewed and contained a health assessment.

LPA discussed a guide for Safe Sleep and the Effects of Lead Exposure with the Director and provided supporting literature for the CCC to provide to the parents of children in care.

This facility is not providing Incidental Medical Services (IMS). Policy was discussed. When any IMS is provided, a Plan for Providing 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

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: 02/18/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/18/2020

LIC809 (FAS) - (06/04)

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