421710529-6-18-2019-17-CC-RGUL-BD9RQL-20190618131343

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 421710529
Report Date: 06/18/2019
Date Signed: 06/18/2019 01:13:51 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:	BETHANIA PRE-SCHOOL		FACILITY NUMBER:	421710529
ADMINISTRATOR:	EILEEN FITZGERALD		FACILITY TYPE:	840
ADDRESS:	611 ATTERDAG ROAD		TELEPHONE:	(805) 688-7077
CITY:	SOLVANG	STATE: CA	ZIP CODE:	93463
CAPACITY:	40	CENSUS: 19	DATE:	06/18/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	12:30 PM
MET WITH:	Eileen Knotts		TIME COMPLETED:	01:25 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	Licensing Program Analysts (LPAs) Ruth Gull and Melissa Stewart conducted an unannounced Annual Random inspection and met with Director, Eileen Knotts. The center was toured inside and out. The Director reported that three teachers and one aide had taken 19 children to the library. LPA observed that there were 19 children signed in on the sign in/out sheet. The children and teachers all returned to the facility during the inspection. The school age classroom was clean and equipped with age appropriate furnishings, toys, books and games. The bathrooms were observed to be clean and free of toxins. The Director reported that there are no guns or ammunition stored at the facility. No bodies of water were observed. The Director reported that she has purchased two carbon monoxide detectors, but they have not yet been installed in the classrooms. The kitchen was observed to be clean. The center provides snacks (menu was reviewed). The outdoor playground areas have age appropriate toys/equipment. The play structures have adequate cushioning materials. Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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: http://www.ada.gov/childqanda.htm continued on 809-C

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Ruth Gull	TELEPHONE: (805) 895-4073
LICENSING EVALUATOR SIGNATURE:	DATE: 06/18/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2019

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: BETHANIA PRE-SCHOOL	FACILITY NUMBER: 421710529
	VISIT DATE: 06/18/2019

NARRATIVE

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A sampling of children and staff records were reviewed. LPA reviewed parent sign in/out sheets. Ms. Knotts and at least 2 teachers have 1st Aid/CPR certificates valid until 3/3/2021. Director was reminded that the Child Care Center regulations could be accessed online at www.ccld.ca.gov. LPA reviewed and provided Director with Effects of Lead Exposure pamphlet which needs to be provided to all current and future parents.

Pursuant to Title 22 of the California Code of Regulations, the following Type A deficiency was cited (refer to LIC 809-D). Upon receipt of this report, licensee shall post and provide copies of this licensing report to parents /guardian of children in care at the facility and to parent/guardians of children newly enrolled at the facility during the next 12 months. Licensee to provide LIC 9224 for each child in care and have each parent sign the form that they have received a copy of the report LIC 809, LIC 809-C and LIC 809 D. Appeal rights given and explained.

The LIC 9213 (Notice of Site visit) was posted during today's visit.

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Ruth Gull	TELEPHONE: (805) 895-4073
LICENSING EVALUATOR SIGNATURE:	DATE: 06/18/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2019

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: BETHANIA PRE-SCHOOL	FACILITY NUMBER: 421710529
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/18/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 06/19/2019 Section Cited HSC 1596.954	1 2 3 4 5 6 7	1596.954 Carbon monoxide detectors required; inspection Every licensed child day care center shall have one or more carbon monoxide detectors in the facility that meet the standards established in Chapter 8 (commencing with Section 13260) of Part 2 of Division 12....	1 2 3 4 5 6 7	The Director stated that she will collect the carbon monoxide detectors today and have them installed in each classroom. Director will submit proof (photos) to LPA by 6/19/19.
	8 9 10 11 12 13 14	This requirement was not met as evidenced by LPA observation and Director's statement that 2 carbon monoxide detectors had been purchased but not yet installed in the classrooms. This poses an immediate risk to the health and safety of children in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Ruth Gull	TELEPHONE: (805) 895-4073
LICENSING EVALUATOR SIGNATURE:	DATE: 06/18/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2019

LIC809 (FAS) - (06/04)

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