421710529-9-16-2021-17-CC-GRES-C6WKQS-20210916080650

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 421710529
Report Date: 09/15/2021
Date Signed: 09/16/2021 08:07:13 AM

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:	LOLA GONZALEZ		FACILITY TYPE:	840
ADDRESS:	611 ATTERDAG ROAD		TELEPHONE:	(805) 688-7077
CITY:	SOLVANG	STATE: CA	ZIP CODE:	93463
CAPACITY:	40	CENSUS: 36	DATE:	09/15/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	02:01 PM
MET WITH:	Lola Gonzalez		TIME COMPLETED:	03:40 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 September 15, 2021 at 2:00 PM Licensing Program Analyst (LPA) Gigi Reyes conducted an unannounced Annual required inspection of the above mentioned Child Care Center (CCC). Prior to inspection, LPA asked pre screening questions related to COVID 19, Director's responses indicate there was no COVID exposure on site. LPA met with Lola Gonzalez , Director of the CCC and explained the nature of the inspection. LPA, in the company of the Director toured the interior and exterior of the CCC. There were 36 school age children 1 qualified teacher, director and an aide present. During the tour, the following was observed, The CCC utilizes the Parish Hall. Classroom is adequately equipped with age and size appropriate furniture and equipment. There is a carbon monoxide in the classroom. Water pitcher supplies drinking water in the indoor activity space. Playground is enclosed by an appropriate fence. Outdoor activity area is equipped with age and size appropriate equipment. An adequate amount of cushioning material is in place under play equipment. Adequate shade is available. Drinking water is provided in the outdoor play area by a water pitcher. 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. A review of staff records on 9/15/2021 indicates that all facility staff have criminal record clearance. Center staff has current Pediatric which expires on 7/22/2023. Sign in and sign out record meets the regulation requirements. AB 1207 Mandated Reporter Training Certificate expires on 3/26/2022

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi Reyes	TELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:	DATE: 09/15/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2021

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: BETHANIA PRE-SCHOOL	FACILITY NUMBER: 421710529
	VISIT DATE: 09/15/2021

NARRATIVE

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Director noted there are no fire arms nor ammunition in the center.

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

In areas evaluated, there was no deficiency cited under Title 22 Division 12 and Health and Safety Code.

THE NOTICE OF SITE VISIT WAS POSTED AS REQUIRED BY H&S CODE SEC. 1596.817. THE NOTICE OF SITE VISIT MUST REMAIN POSTED FOR 30 DAYS OR A CIVIL PENALTY OF $100.00 WILL BE ASSESSED.

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi Reyes	TELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:	DATE: 09/15/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2021

LIC809 (FAS) - (06/04)

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