<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426200196
Report Date: 09/29/2022
Date Signed: 09/29/2022 03:50:53 PM


Document Has Been Signed on 09/29/2022 03:50 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 - ALVIN CENTERFACILITY NUMBER:
426200196
ADMINISTRATOR:MARIA BEASFACILITY TYPE:
850
ADDRESS:316 E. MCELHANYTELEPHONE:
(805) 347-1975
CITY:SANTA MARIASTATE: CAZIP CODE:
93454
CAPACITY:23CENSUS: 16DATE:
09/29/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:20 PM
MET WITH:Maria BeasTIME 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 9/29/2022 at 1:20 PM , Licensing Program Analyst (LPA) Gigi Reyes made an unannounced Case Management inspection at the CAC – Alvin Site Child Care Center. LPA met with Site Supervisor Maria Beas and discussed the purpose of the inspection. The inspection was a follow up to a self reported incident regarding a child in care who was left in the play ground for 17 minutes without supervision.

LPA accompanied by the Site Supervisor toured the Center’s classroom and the outside activity area.. LPA observed 15 napping children, one child was reading. and 6 Staff present at the time of the inspection.

LPA's interview with Site Supervisor revealed that , on or about 11:30 AM on 9/28/2022, the children went inside the classroom to take lunch. Director stated that Center's protocol in the transition is by head count and by marking the children's names once they are seated at the chair/table. On or about 11:47 AM while children were eating lunch, Staff 1 (S1) observed Child 1 (C1) walkiing towards the Pres School classroom. Based on the report and (Staff 3) interview with C1, C1 was in the play structure when children were all going inside the classroom. The play structure where C1 was left , was 85 feet away from the classroom.

Site Supervisor stated that they have implemented additional action plan on how to ensure that all day care children are present and accounted for during transitions.

During today's inspection, deficiency was cited under Title 22 Division 12. An immediate civil penalty of $500.00 was assessed.
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi ReyesTELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:
DATE: 09/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/29/2022
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 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 - ALVIN CENTER
FACILITY NUMBER: 426200196
VISIT DATE: 09/29/2022
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
26
27
28
29
30
31
32
LPA Reyes informed Site Supervisor, Maria Beas that this report dated 9/29/2022 documents one Type A citation which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care. Also, LPA Reyes informed the Site Supervisor, Maria Beas to provide a copy of this licensing report dated 9/29/2022 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Notice of Site Visit was issued.

Exit interview was conducted and report was reviewed with Site Supervisor, Ms. Maria Beas
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi ReyesTELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:

DATE: 09/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/29/2022
LIC809 (FAS) - (06/04)
Page: 3 of 3
Document Has Been Signed on 09/29/2022 03:50 PM - It Cannot Be Edited

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 - ALVIN CENTER
FACILITY NUMBER: 426200196

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/29/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/30/2022
Section Cited

1
2
3
4
5
6
7
101229(a)(1)
(a) The licensee shall provide care and supervision as necessary to meet the children's needs.(1) No child(ren) shall be left without the supervision of a teacher at anytime...
This requirement is not met as evidenced by :
8
9
10
11
12
13
14
Based on the report and interview conducted, C1 was left in the play yard for approximatley 17 minutes without supervision. This poses an immediate risk to health and safety and personal risk 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
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: 09/29/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/29/2022
LIC809 (FAS) - (06/04)
Page: 2 of 3