421710360-6-9-2022-17-CC-GRES-CF8RN6-20220609130948

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 421710360
Report Date: 06/09/2022
Date Signed: 06/09/2022 01:09:54 PM

Document Has Been Signed on 06/09/2022 01:09 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:	PACIFIC CHRISTIAN SCHOOL		FACILITY NUMBER:	421710360
ADMINISTRATOR:	CALDERWOOD, MAUREEN		FACILITY TYPE:	850
ADDRESS:	3435 SANTA MARIA WAY		TELEPHONE:	(805) 938-7555
CITY:	SANTA MARIA	STATE: CA	ZIP CODE:	93455
CAPACITY:	90	CENSUS: 71	DATE:	06/09/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Maureen Calderwood		TIME COMPLETED:	01:15 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 June 9, 2022 at 9:00 AM, Licensing Program Analyst (LPA) Gigi Reyes conducted an unannounced 1 Year Required Inspection and met with Director Ms. Maureen Calderwood. LPA explained the purpose of the inspection. Prior to inspection LPA asked pre screening questions related to COVID -19 and responses indicate there are no COVID-19 exposure on site. The Child Care Center operates Monday to Friday, 6:30 AM to 5:30 PM. LPA in the company of Ms. Calderwood toured the Center inside and out. There were 71 day care children and 10 Staff present. Licensing required forms are posted in the hallway entrance. The outdoor playground is enclosed with the wire fences, It has age appropriate toys and equipment. The playground has an ample amount of sand cushioning. The center has drinking water available for children inside and out. The outside activity space is clean and free of hazardous items. LPA reviewed sign in/sign out which meets the regulation requirements. A sampling of children and staff records were reviewed. Teachers qualifications were verified. Teachers present have current Pediatric First Aid/CPR certificates that expire on 8/11/2023. All staff have current Mandated Reporter Training. LPA verified SB 792 Child Care Adult Immunization record and tuberculosis requirements. During today's inspection, no deficiencies were cited. Continued on LIC 809C

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi Reyes	TELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:	DATE: 06/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2022

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: PACIFIC CHRISTIAN SCHOOL	FACILITY NUMBER: 421710360
	VISIT DATE: 06/09/2022

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
26
27
28
29
30
31
32

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.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.

Director 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 Director, Ms. Maureen Calderwood.

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi Reyes	TELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:	DATE: 06/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2022

LIC809 (FAS) - (06/04)

Page: 2 of 2