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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426200093
Report Date: 10/14/2020
Date Signed: 10/14/2020 11:56:23 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:ST. RAPHAEL SCHOOL/PRESCHOOLFACILITY NUMBER:
426200093
ADMINISTRATOR:SANTOS, EDNA L.FACILITY TYPE:
850
ADDRESS:160 ST. JOSEPH STREETTELEPHONE:
(805) 967-4435
CITY:SANTA BARBARASTATE: CAZIP CODE:
93111
CAPACITY:81CENSUS: 9DATE:
10/14/2020
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
11:05 AM
MET WITH:Michelle LimbTIME COMPLETED:
11:30 AM
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On October 14, 2020 at 11:05am, Licensing Program Analyst (LPA) Ruth Gull conducted a CASE MANAGEMENT tele-video inspection via FaceTime (due to COVID-19 State of Emergency). LPA met with School Principal, Michelle Limb regarding the request for a decrease in capacity to 27 children. A virtual tour of the one classroom, bathrooms and playground was completed. There were 9 children with Director Edna Santos and one teacher on the playground.

The classroom was previously measured as 960 square feet which meets the requirements for 27 children. There are 2 bathrooms next to the classroom. There are a total of 6 sinks, 3 toilets, and 1 urinal which meets the requirements for 60 children.

The playground was previously measured as 5,760 square feet which meets the requirement for 76 children.

License capacity decrease to 27 children will be effective once the fire clearance is granted.

Exit interview was conducted with Michelle Limb. This report will be sent to the Principal via email with a read receipt or confirmation of receipt of email, which will act as the Principal's signature.
Notice of Site Visit (LIC9213) will also be e-mailed to the Principal. The notice shall be posted for 30 consecutive days. Failure to maintain posting as required will result in a $100.00 civil penalty.
SUPERVISOR'S NAME: Ana TolentinoTELEPHONE: (805) 562-0437
LICENSING EVALUATOR NAME: Ruth GullTELEPHONE: (805) 895-4073
LICENSING EVALUATOR SIGNATURE:

DATE: 10/14/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/14/2020
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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