426206965-4-13-2023-17-CC-EBAY-CQUU9K-20230413152317

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 426206965
Report Date: 04/13/2023
Date Signed: 04/13/2023 03:24:03 PM

Document Has Been Signed on 04/13/2023 03:24 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:	ORFALEA FAMILY CHILDREN'S CENTER CLUB HOUSE		FACILITY NUMBER:	426206965
ADMINISTRATOR:	ANNETTE MUSE		FACILITY TYPE:	850
ADDRESS:	UCSB, WEST CAMPUS		TELEPHONE:	(805) 893-3665
CITY:	SANTA BARBARA	STATE: CA	ZIP CODE:	93106
CAPACITY:	23	CENSUS: 0	DATE:	04/13/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Tamara Thompson		TIME COMPLETED:	10:30 AM

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On 4/13/23, at 10:00 AM, Licensing Program Analysts (LPAs) Elvin Baddley and Dixie Wright conducted an unannounced One Year Required Inspection the abovementioned Child Care Center (CCC). The LPA met with Tamara Thompson Director of the CCC and explained the purpose of the inspection. LPA, in the company of Director, toured the interior and exterior of the CCC. The CCC is on the grounds of the California University of Santa Barbara's West Campus. The CCC, also known as the Turquoise Room, operates from 7:30 AM-5:20 PM, Monday - Friday. The preschool uses a single room for child care which is subdivide into activity areas . LPAs observed no children on site during the inspection.

LPAs observed and reviewed licensing required notices and documents posted predominately near the entry door of the CCC. Likewise, LPA observed Sign In/Out forms near the entry of the CCC which contains the signature of authorized representatives and the arrival and departure times of children in care.

LPAs observed the room used for childcare to be clean and organized. The room has age appropriate toys and furnishings available for children in care. The CCC has a carbon monoxide detector which was tested at 9:58 AM and found to be operable.The restroom used for care is in safe and sanitary operating condition. LPA observed an operable refrigerator in the CCC's kitchen area which contains some food items for the children’s consumption. The CCC provides (morning and mid day) snack for children, while lunches can be provided by either parents or the CCC. CCC staff inspect the children's lunches to ensure the lunches contain healthy items from the essential food groups. LPA notes there is available drinking water (water hydration stations) for children both inside the CCC and outside in the play area. The facility’s water sources have been tested for lead containments and test results are posted. Disinfectants, cleaning solutions, sharps and medications in CCC are located in areas which are inaccessible to children in care.

The CCC's outdoor playground area is enclosed by chain link fencing. LPAs note the footing in the area is varied. The fences' entry/exit gates are secured. LPA observed age appropriate toys and play equipment in the play areas. The toys and play equipment are in suitable condition and free of sharp, loose or pointed objects. The play structures in the playground areas have cushioning materials to absorb falls and an

(CONT. LIC 809-C)

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Elvin Baddley	TELEPHONE: (805) 635-4697
LICENSING EVALUATOR SIGNATURE:	DATE: 04/13/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/13/2023

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: ORFALEA FAMILY CHILDREN'S CENTER CLUB HOUSE	FACILITY NUMBER: 426206965
	VISIT DATE: 04/13/2023

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abundance of shade created by trees and building overhangs. Director is reminded to replace toys and play equipment which have began degraded and is in not good repair. No bodies of water were observed on site. Waste receptacles with tight fitting covers were observed throughout the CCC.

A sampling of 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 found to contain current pediatric CPR and First Aid certifications (EMSA approved) as well as Mandated Report certifications. Director informed LPA no firearm or ammunition are stored on the premises.

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 Tamara Thompson.

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Elvin Baddley	TELEPHONE: (805) 635-4697
LICENSING EVALUATOR SIGNATURE:	DATE: 04/13/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/13/2023

LIC809 (FAS) - (06/04)

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