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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426206950
Report Date: 06/23/2022
Date Signed: 06/23/2022 04:58:57 PM


Document Has Been Signed on 06/23/2022 04:58 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. MARY'S SCHOOLFACILITY NUMBER:
426206950
ADMINISTRATOR:MARY ROWELLFACILITY TYPE:
850
ADDRESS:309 SOUTH SCHOOLTELEPHONE:
(805) 346-6541
CITY:SANTA MARIASTATE: CAZIP CODE:
93454
CAPACITY:57CENSUS: 10DATE:
06/23/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Lupe Fernandez TIME COMPLETED:
04:45 PM
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On 6/23/22, at 1:30 PM, Licensing Program Analyst (LPA) Elvin Baddley conducted an unannounced One Year Required inspection of the abovementioned Child Care Center (CCC). LPA met with Lupe Fernandez, Director of the CCC, and explained the purpose of the inspection. LPA, in the company of the Director toured the interior and exterior of the CCC. The CCC operates three classroom and an outdoor play area at the noted address. The CCC's hours of operation are from 6:30 AM to 6:00 PM, Monday - Friday. During the inspection, LPA observed 10 children in care, along with 3 teachers (clear and associated) providing supervision.

The classrooms used for child care are clean and organized. The CCC has an operable refrigerator in the kitchen area which is inaccessible to children in care. The refrigerator contains food items consumed by the children which are labeled and dated. The CCC provides snacks. Lunch are provided by the parents of children in care. Staff inspect the foods to ensure the food choice are healthy and void of junk foods. LPA notes bottled drinking water is available for children is inside and outside. LPA informed Director of requirement to have CCC's water sources lead tested. LPA observed menus posted at the CCC along with required notices and documents near the facility's entry door. The CCC has storage space ("cubbies") for all children in care near the entry of the facility and age appropriate furnishings, toys and equipment throughout. LPA reviewed CCC Sign In/Out documents and notes all documents reviewed were found to be completed appropriately, having the authorized parent's signature as well as entry and exit times of the children.

LPA observed a carbon monoxide detector on site which was tested at 3:15 AM and found to be operable. Disinfectants and cleaning solutions are stored in cabinets in the CCC's outdoor laundry area which is inaccessible to children. Sharps and medications at the CCC are out of the reach of children in care and inaccessible. The restrooms of the CCC are observed to be clean and void of toxins. Waste receptacles at the CCC are observed to have tight fitting lids.
(CONT 809-C)
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Elvin BaddleyTELEPHONE: (805) 635-4697
LICENSING EVALUATOR SIGNATURE:
DATE: 06/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/23/2022
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: ST. MARY'S SCHOOL
FACILITY NUMBER: 426206950
VISIT DATE: 06/23/2022
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The outdoor playground area is in the center of the facility. Furnishings, toys and equipment in the outdoor area is age appropriate. The play structures in the outdoor play area have adequate cushioning materials to absorb falls (i.e.sand) . LPA observed a water table in the outdoor play area. Director informed LPA the water table is emptied daily after each use. Children using water tables are directly supervised CCC staff Play structure are absent of sharp, pointed or loose parts. Director was reminded to replace outdoor equipment once the play equipment begins to degraded.

Staff and children records were reviewed. The children’s records were complete and found to contain emergency contact information as well as immunization records. Staff records were reviewed and contained current pediatric CPR and First Aid certifications (EMSA) along with Mandated Reporter certifications. Director was reminded to keep training certifications current and updated prior to expirations. Director notes no firearm or ammunition is stored on site. LPA notes the last fire/disaster drill occurred on 3/30/22.

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

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 Lupe Fernandez.
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Elvin BaddleyTELEPHONE: (805) 635-4697
LICENSING EVALUATOR SIGNATURE:

DATE: 06/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/23/2022
LIC809 (FAS) - (06/04)
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