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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 421711023
Report Date: 06/10/2019
Date Signed: 06/11/2019 01:32:03 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:ORFALEA CHILDREN'S CENTER LAB SCHOOL AT AHCFACILITY NUMBER:
421711023
ADMINISTRATOR:MAGDALENA RAMOSFACILITY TYPE:
850
ADDRESS:800 SOUTH COLLEGE DRIVETELEPHONE:
(805) 922-6966
CITY:SANTA MARIASTATE: CAZIP CODE:
93454
CAPACITY:78CENSUS: 20DATE:
06/10/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
11:01 AM
MET WITH:Magdalena RamosTIME COMPLETED:
04:00 PM
NARRATIVE
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Licensing Program Analyst (LPA) Gigi Reyes conducted an unannounced annual/random and met with Director, Ms. Magdalena Ramos. The purpose of the visit was discussed. There were 20 children and 7 teachers present including the Director.

The Preschool is located at Allan Hancock College Campus, preschool is using the room I 205 (J12) and I 204 (J13). The physical plant tour was conducted. Classrooms are observed to be clean and in order. The bathrooms are clean and free of toxins. The surface of the outdoor activity space is maintained, in safe condition and free of hazards. LPA observed the presence of carbon monoxide detector in each room. Director stated there are no guns nor ammunition in the Center. LPA did not observe bodies of water in the premises.
Drinking fountains supply drinking water in the playground and in each classroom.

A review of staff records and children's records were conducted as part of this evaluation. Children's files were randomly reviewed and found complete. LPA observed Child 1 and Child 2 were not signed in. CPR and First Aid expires in 2/11/2021. Staff 1, 3,5 and 6 have no proof of AB 1207 Mandated Reporter Training Certificate. Staff 2,3 and 5 do not have educational verification on file. Staff 3 has no record of immunization.

Continued on 809C


SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi ReyesTELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:

DATE: 06/10/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/10/2019
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 4
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: ORFALEA CHILDREN'S CENTER LAB SCHOOL AT AHC
FACILITY NUMBER: 421711023
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/10/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/19/2019
Section Cited
CCR
101229.1(b)
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(b) The person who brings the child to, and removes the child from the center shall sign the child in/out.




This requirement is not met as evidenced by:
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Director agreed to submit a written plan of correction to CCLD no later than 6/19/2019 on how to ensure that day care children are signed in and signed out by their parents/legal guardian and/or authorized representative.
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Based on LPA's review of sign in and sign out,
it was observed that Child 1 and Child 2 were not signed in today. Director stated that the lead teacher had contacted the parents of the children. This poses a potential risk to health and safety of children in care.
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Type B
06/19/2019
Section Cited
HSC
1596.7995
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(a) (1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.
This requirement is not met as evidenced by:
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Director agreed to submit the proof of immunization for Staff 3 to CCLD no later than 6/19/2019.
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Based on LPA's review of record, it was observed that Staff 3 does not have proof of immunization on file. This poses a potential risk to health and safety of children in care.
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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 MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi ReyesTELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:

DATE: 06/10/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/10/2019
LIC809 (FAS) - (06/04)
Page: 2 of 4
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: ORFALEA CHILDREN'S CENTER LAB SCHOOL AT AHC
FACILITY NUMBER: 421711023
VISIT DATE: 06/10/2019
NARRATIVE
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Center is not providing Incidental Medical Services (IMS). 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

In the areas evaluated, deficiencies were cited under Title 22 Division 12 and Health and Safety Code. (809D) Appeal Rights given.

LPA observed Director posted the Notice of Site Visit.
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi ReyesTELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:

DATE: 06/10/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/10/2019
LIC809 (FAS) - (06/04)
Page: 3 of 4
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: ORFALEA CHILDREN'S CENTER LAB SCHOOL AT AHC
FACILITY NUMBER: 421711023
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/10/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/19/2019
Section Cited
CCR
101217(a)(6)
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(a) The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. Each personnel record shall contain the following information:(6) Documentation of the educational background, training and/or experience specified in this chapter.
This requirement is not met as evidenced by:
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Director agreed to submit a the proof of educational background to CCLD no later than 6/19/2019.
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Based on LPA's review of records, it was observed tha Staff 2,3 and Staff 5 do not have the verification of educational background on file. This poses a potential risk to health and safety of children in care.
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Type B
06/19/2019
Section Cited
HSC
1596.8662(b)(1)
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(b) (1)   On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training ... shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.
This requirement is not met as evidenced by:
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Director agreed to submit the AB1207 Certificate for Straff 1,3,5 and 6 to CCLD no later than 6/19/2019.
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Based on LPA's review of record, it was observed that Staff 1, 3, 5 and 6 do not have the proof that AB 1207 Mandated Reporter Training was taken. Director stated, they are taking the AB 1207 every Fall season.
This poses a potential risk to health and safety of children in care.
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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 MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi ReyesTELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:

DATE: 06/10/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/10/2019
LIC809 (FAS) - (06/04)
Page: 4 of 4