426205725-4-5-2022-17-CC-FVEZ-CD7SCR-20220405134558

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 426205725
Report Date: 04/05/2022
Date Signed: 04/05/2022 01:46:08 PM

Document Has Been Signed on 04/05/2022 01:46 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:	CAPSLO - BONITA MIGRANT AND SEASONAL HEAD START		FACILITY NUMBER:	426205725
ADMINISTRATOR:	A.RAMIREZ-BARRON		FACILITY TYPE:	850
ADDRESS:	4685 EAST 11TH STREET		TELEPHONE:	(805) 343-0324
CITY:	GUADALUPE	STATE: CA	ZIP CODE:	93434
CAPACITY:	40	CENSUS: 11	DATE:	04/05/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Maria Camacho		TIME COMPLETED:	01:50 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 4/5/22, at 10:00 AM, Licensing Program Analyst (LPA) Francisca Velazquez conducted an unannounced Required Annual inspection of the abovementioned Child Care Center (CCC). LPA met with Maria Camacho, Site Supervisor of the CCC and explained the purpose of the inspection. LPA, in the company of the Site supervisor, toured the interior and exterior of the CCC. The CCC is located in a single level building. The CCC operates from 6:00 AM to 4:00 PM, Monday - Friday. During this inspection there were three (3) toddler age children supervised by two (2) staff and eight (8) preschool age children supervised by two (2) staff. The CCC has a population of 11 children in care at the time of the inspection along with eight (8) staff in the facility. The classroom has age appropriate equipment and furnishings available to children in care. LPA observed a carbon monoxide detector in each classroom which were tested at 10:53 AM and found to be operable. There are three (3) toilets, four (4) sinks used by the children in care. All restrooms are in sanitary operating condition with hand washing soap and paper towels. LPA observed an operable refrigerator in the kitchen of the facility which contained food. The facility provides all snack and meals for the children. LPA reviewed a posted menu on the kitchen. All required licensing notices and documents are posted by the entrance of the facility. The CCC has available (filtered) water for children inside and outside of the facility by means of water jugs and disposable cups. Disinfectants and cleaning solutions are observed in elevated locked cabinets in the kitchen of the facility and in the staff restroom in a locked cabinet. Disinfects are observed throughout the classroom accessible to the teaching staff but inaccessible to the 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: 04/05/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/05/2022

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: CAPSLO - BONITA MIGRANT AND SEASONAL HEAD START	FACILITY NUMBER: 426205725
	VISIT DATE: 04/05/2022

NARRATIVE

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The CCC's medications are stored in an elevated cabinet that is locked. At the moment no enrolled children have medication at the facility. The Sign In/Out form for children is done daily. All children present during this inspection were signed in.

The CCC outdoor playground areas are enclosed by chain linked fencing. The fence’s entry/exit gates are secured. LPA observed age appropriate toys/play equipment in the play areas. The toys/play equipment are free of sharp, loose or pointed objects. The play structures in the playground areas have adequate cushioning materials in the form of wooden chips to absorb falls. All outdoor play yards offer plenty of shade. No bodies of water are observed on site. LPA notes that toddler children, and pre-school age children all have their own designated outdoor play area.

A sampling of staff and children records were reviewed. The children’s records were complete and found to contain emergency contact information. Staff records were reviewed and contained documentation to support CPR/First Aid training. Director noted no firearms or ammunition is stored on site. LPA reviewed infant safe sleep regulations and left for Site Supervisor to review. Facility staff has been trained on 15 minute sleep log and will start documenting toddler's sleep effective immediately.

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 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: 04/05/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/05/2022

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: CAPSLO - BONITA MIGRANT AND SEASONAL HEAD START	FACILITY NUMBER: 426205725
	VISIT DATE: 04/05/2022

NARRATIVE

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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.

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, Maria Camacho.

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisca Velazquez	TELEPHONE: (805) 883-8244
LICENSING EVALUATOR SIGNATURE:	DATE: 04/05/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/05/2022

LIC809 (FAS) - (06/04)

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