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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426206807
Report Date: 11/09/2022
Date Signed: 11/09/2022 03:27:30 PM


Document Has Been Signed on 11/09/2022 03:27 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:ST. VINCENT'S EARLY CHILDHOOD EDUCATION CENTERFACILITY NUMBER:
426206807
ADMINISTRATOR:SUSANA DEL TOROFACILITY TYPE:
850
ADDRESS:4200 CALLE REAL,4225/4233TELEPHONE:
(805) 683-6381
CITY:SANTA BARBARASTATE: CAZIP CODE:
93110
CAPACITY:74CENSUS: 20DATE:
11/09/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:10 PM
MET WITH:Maite EstradaTIME COMPLETED:
03:35 PM
NARRATIVE
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On November 9th, 2022 at 2:10PM Licensing Program Analyst (LPA) Rosie Breault made an unannounced inspection for the purpose of conducting a Case Management - Incident inspection. LPA conducted a Covid-19 prescreening and no exposure on site. LPA met with facility Assistant Director Maite Estrada and discussed the purpose of the visit. LPA and assistant director conducted a tour of the facility inside and out. At the time of the inspection there were 20 children and 3 staff.

On 11/8/2022, assistant director, Maite Estrada contacted Community Care Licensing (CCL) to self-report an incident of a child being injured and subsequently taken to urgent care while playing near the sandbox.

At inspection, assistant director stated C1 was playing in the sandbox with roughly an additional five (5) children. Teacher Sonja Aguilar was present; however back turned away from the children in the sandbox. Assistant director Estrada was also providing care and supervision to children but away from sandbox on an uphill grassy area with limited visual on sandbox. Neither teachers saw the incident occur; however, it was witness by kitchen staff member, Sandy Lopez. This is a violation of Title 22 Division 101229. LPA observed sandbox near a small walkway. C1 was jumping from sandbox onto ground that was additionally covered in sand. C1 slipped and fell onto concrete, hitting the back of head. Ms. Lopez saw incident and Teacher Aguilar turned to C1 once C1 fell. Teachers provided ice and C1 began to cry. At lunchtime, Teacher Sonja noticed C1 did not have an appetite and at roughly 12:23PM alerted assistant director Estrada that C1 had vomited (twice while present at school). C1 parent was called and C1 taken by parent to Urgent Care then to Cottage Hospital where it was determined C1 had a concussion. Mother of C1 was in communication with assistant director and stated C1 was doing fine and cleared to return to school with a doctor’s note. C1 has not returned to date due to a cold. Parent did not indicate that facility should provide any medication to C1 upon return.

CONTINUED ON LIC809C

SUPERVISOR'S NAME: Ana TolentinoTELEPHONE: (805) 562-0347
LICENSING EVALUATOR NAME: Maryrose BreaultTELEPHONE: (805) 635-5097
LICENSING EVALUATOR SIGNATURE:
DATE: 11/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/09/2022
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: ST. VINCENT'S EARLY CHILDHOOD EDUCATION CENTER
FACILITY NUMBER: 426206807
VISIT DATE: 11/09/2022
NARRATIVE
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At inspection, LPA observed sand has been removed from ground area and replaced with grass turf to prevent slipping.

Per Title 22 Division 12 101229 (a) (1) a Type B deficiency was issued to facility and provided to assistant director.

Appeal Rights provide to assistant director.

The Notice of Site Visit was given to assistant director and must remain posted for 30 days.

SUPERVISOR'S NAME: Ana TolentinoTELEPHONE: (805) 562-0347
LICENSING EVALUATOR NAME: Maryrose BreaultTELEPHONE: (805) 635-5097
LICENSING EVALUATOR SIGNATURE:

DATE: 11/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/09/2022
LIC809 (FAS) - (06/04)
Page: 2 of 3
Document Has Been Signed on 11/09/2022 03:27 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: ST. VINCENT'S EARLY CHILDHOOD EDUCATION CENTER
FACILITY NUMBER: 426206807

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/09/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/09/2022
Section Cited

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No children shall be left without the supervision of a teacher at any time...
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This evidence is met by:
Assistant director indicated visual observation was not met by either teachers present.
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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 TolentinoTELEPHONE: (805) 562-0347
LICENSING EVALUATOR NAME: Maryrose BreaultTELEPHONE: (805) 635-5097
LICENSING EVALUATOR SIGNATURE:
DATE: 11/09/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/09/2022
LIC809 (FAS) - (06/04)
Page: 3 of 3