426206158-1-12-2023-17-CC-MBRT-CN22SZ-20230112163958

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 426206158
Report Date: 01/12/2023
Date Signed: 01/12/2023 04:40:05 PM

Document Has Been Signed on 01/12/2023 04:40 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:	SANTA BARBARA BRANCH - HOPE ELEMENTARY SCHOOL		FACILITY NUMBER:	426206158
ADMINISTRATOR:	GABRIEL OSOLLO		FACILITY TYPE:	840
ADDRESS:	3970 LA COLINA RD.		TELEPHONE:	(805) 563-9912
CITY:	SANTA BARBARA	STATE: CA	ZIP CODE:	93110
CAPACITY:	52	CENSUS: 25	DATE:	01/12/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	02:25 PM
MET WITH:	Vanessa Ramirez		TIME COMPLETED:	04:47 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 January 12th at 2:20PM Licensing Program Analyst (LPA) Rosie Breault conducted an unannounced annual random inspection. LPA met with Site Supervisor Vanessa Ramirez and explained the purpose of the inspection. The center operates Monday – Friday 1:30PM – 5:30PM. The center is located on the grounds of Hope Elementary School. A tour of the facility was made. At the time of the inspection, there were twenty-five (25) children and four (4) staff. Facility currently uses written sheets for sign in and out purposes and electronic E-pad through the YMCA. LPA observed mandated licensing postings and snack menu for the month of January 2023 posted prominently. Facility is currently utilizing one (1) classroom and LPA noted both have age-appropriate toys/equipment and furnishings. Filter water is available for children’s use and children bring personal water bottles. Facility has one restroom available for children and toilet / sink functioning at time of inspection. LPA did not observe any toxins, combustibles, poisons, sharps, or hazardous items accessible to children and the last fire drill was conducted on 12/8/2022. Children use the Hope Elementary play yard for outdoor recreation. No bodies of water are present. Incidental Medical Services are not being provided at this time. A sampling of children and staff records were reviewed. LPA reviewed SB 792 (Child Care Employee and Volunteer Immunization and Tuberculosis Requirements) and three teachers Mandated Reporter training certificates which are valid and current. One teacher does not have valid Mandated Reporter Training and a Technical Violation will be issued. All teachers present do not have valid/current Pediatric CPR/First Aid which is in violation of Health and Safety Code 1596.866 (b) and a Type B citation will be issued. CONTINUED ON LIC809C

SUPERVISOR'S NAME: Ana Tolentino	TELEPHONE: (805) 562-0347
LICENSING EVALUATOR NAME: Maryrose Breault	TELEPHONE: (805) 635-5097
LICENSING EVALUATOR SIGNATURE:	DATE: 01/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/12/2023

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: SANTA BARBARA BRANCH - HOPE ELEMENTARY SCHOOL	FACILITY NUMBER: 426206158
	VISIT DATE: 01/12/2023

NARRATIVE

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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.

Deficiencies cite are attached on LIC809D

Exit interview conducted with site supervisor and copy provided. Appeal Rights provided.

THE NOTICE OF SITE VISIT WAS POSTED AS REQUIRED BY H&S CODE SEC. 1596.817. THE NOTICE OF SITE VISIT MUST REMAIN POSTED FOR 30 DAYS OR A CIVIL PENALTY OF $100.00 WILL APPLY.

SUPERVISOR'S NAME: Ana Tolentino	TELEPHONE: (805) 562-0347
LICENSING EVALUATOR NAME: Maryrose Breault	TELEPHONE: (805) 635-5097
LICENSING EVALUATOR SIGNATURE:	DATE: 01/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/12/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 01/12/2023 04:40 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: SANTA BARBARA BRANCH - HOPE ELEMENTARY SCHOOL	FACILITY NUMBER: 426206158
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/12/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.866

Day care center directors shall ensure one staff member....has pediatric CPR... approved by Emergency Medical Services Authority This requirement is not met as evidenced by: Four staff did not have current/valid CPR per regulation.
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in four counts out of four which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 01/31/2023
	Plan of Correction
1 2 3 4	All staff members are to complete Pediatric CPR/ First Aid by either the American Red Cross, American Heart Association or another EMSA certified program. Director to submit certificates to LPA Rosie Breault @ maryrose.breault@dss.ca.gov by 1/31/2023

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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: Ana Tolentino	TELEPHONE: (805) 562-0347
LICENSING EVALUATOR NAME: Maryrose Breault	TELEPHONE: (805) 635-5097
LICENSING EVALUATOR SIGNATURE:	DATE: 01/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/12/2023

LIC809 (FAS) - (06/04)

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