421712020-2-17-2022-17-CC-FVEZ-CBR278-20220217160820

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 421712020
Report Date: 02/09/2022
Date Signed: 02/17/2022 04:08:31 PM

Document Has Been Signed on 02/17/2022 04:08 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:	CAC - SIERRA MADRE CENTER		FACILITY NUMBER:	421712020
ADMINISTRATOR:	CASSANDRA HART		FACILITY TYPE:	850
ADDRESS:	1002 E. SIERRA MADRE AVE.		TELEPHONE:	(805) 349-9707
CITY:	SANTA MARIA	STATE: CA	ZIP CODE:	93454
CAPACITY:	50	CENSUS: 25	DATE:	02/09/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:30 PM
MET WITH:	Carla Ayala & Bertha Heredia		TIME COMPLETED:	04:45 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 2/9/22, at 12:30 AM, Licensing Program Analyst (LPA) Francisca Velazquez conducted an unannounced Required Inspection the abovementioned Child Care Center (CCC). The LPA met with Carla Ayla, Site supervisor of the CCC and explained the purpose of the inspection. LPA, in the company of Site Supervisor, toured the interior and exterior of the CCC. The center operates from 7:00 AM to 5:15 PM, Monday - Friday and offers full day and part day services. The preschool uses two classrooms for child care services, along with outdoor play yard. LPA notes there are twenty-five (25) preschool age children present being cared by four (4) teaching staff and one (1) teaching aide in addition, CCC cook and CCC Family Service Advocate were present. All staff personnel present during today’s inspection are cleared and associated to the CCC. The classrooms used for child care are clean and organized. The classrooms have age appropriate toys and furnishings available for children. LPA observed various learning areas available for the children throughout the day. The CCC has carbon monoxide detector in entrance of the facility. Carbon monoxide detector was not tested due to day care children napping during the time of this inspection. Site Supervisor reported that the CCC conducts emergency drills once every month and part of their emergency drill procedure is to check carbon monoxide detector. The restrooms used for day care are in safe and sanitary operating condition. LPA observed plenty of handwashing soap, paper towels and hand washing posters accessible to the day care children. The CCC provides all food for the day care children. The CCC provides Breakfast, an AM and PM snack and lunch. LPA observed the CCC menu posted in the kitchen area in the CCC. LPA observed that the kitchen is clean and all items in the refrigerator are labeled. LPA observed there is available drinking water for children both inside the classroom and outside in the play area. Disinfectants, cleaning solutions, sharps and medications are stored on and in elevated cabinets throughout the CCC. Each location is inaccessible to children in care. CONT 809-C

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisca Velazquez	TELEPHONE: (805) 883-8244
LICENSING EVALUATOR SIGNATURE:	DATE: 02/17/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/17/2022

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: CAC - SIERRA MADRE CENTER	FACILITY NUMBER: 421712020
	VISIT DATE: 02/09/2022

NARRATIVE

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The CCC's outdoor playground area is enclosed by wrought iron fencing. The fences' entry/exit gates are secured. LPA observed age appropriate toys and play equipment in the play areas. LPA also observed numerous shed in the outdoor activity areas which were secured by lock and contained CCC supplies. The toys and play equipment in the outdoor areas are in suitable condition and free of sharp, loose or pointed objects. The play structures in the playground areas have cushioning materials to absorb falls and an abundance of shade created by trees and building overhangs. No bodies of water were observed on site. Waste receptacles with tight fitting covers were observed throughout the CCC.

LPA reviewed posted menus along with licensing required notices and documents posted predominately in the CCC. LPA reviewed the facility's Sign in Sign Out forms upon arrival at the CCC. LPA noted the arrival times of children in care and as well as notations from authorized representatives/parents on the forms. All children present in the facility were signed in today.

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 pediatric CPR and First Aid certifications as well as Mandated Report certifications. Site Supervisor informed LPA no firearm or ammunition are stored on the premises.

This facility provides Incidental Medical Services – IMS, however there are no children using IMS services at this time. 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

Facility representative 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.

CONT 809-C

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisca Velazquez	TELEPHONE: (805) 883-8244
LICENSING EVALUATOR SIGNATURE:	DATE: 02/17/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/17/2022

LIC809 (FAS) - (06/04)

Page: 2 of 3

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: CAC - SIERRA MADRE CENTER	FACILITY NUMBER: 421712020
	VISIT DATE: 02/09/2022

NARRATIVE

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A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Facility representative Bertha Heredia.

On 2/9/22 at around 4:00 PM, LPAs laptop went on consistency check. LPA left the facility and explained to site supervisor that LPA will return at a later day to gather signatures for reports written on 2/9/22. LPA returned on 2/17/22 and met with facility representative, Bertha Heredia to review and sign reports.

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisca Velazquez	TELEPHONE: (805) 883-8244
LICENSING EVALUATOR SIGNATURE:	DATE: 02/17/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/17/2022

LIC809 (FAS) - (06/04)

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