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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426207286
Report Date: 05/23/2023
Date Signed: 05/23/2023 11:24:26 AM


Document Has Been Signed on 05/23/2023 11:24 AM - 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:SBCEO - SANTA YNEZ VALLEY STATE PRESCHOOLFACILITY NUMBER:
426207286
ADMINISTRATOR:JANELLE WILLISFACILITY TYPE:
850
ADDRESS:3525 PINETELEPHONE:
(805) 686-7317
CITY:SANTA YNEZSTATE: CAZIP CODE:
93460
CAPACITY:25CENSUS: 0DATE:
05/23/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:13 AM
MET WITH:Patricia SandovalTIME COMPLETED:
11:38 AM
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On May 23rd, 2023, at 10:13AM Licensing Program Analyst (LPA) Rosie Breault conducted an unannounced Annual/Random inspection. LPA met with Associate Teacher Patricia Sandoval and advised her the purpose of the inspection. At the time of the inspection zero (0) children were present, the center operates Monday through Friday 12:00pm – 3:00pm. Teacher provided LPA a tour of center inside and out.

LPA observed required licensing documents mounted on the wall at the entrance of the facility. Parents use app mSign for the purposes of signing in and out. The facility is currently utilizing one (1) classroom for care and supervision. LPA notes classroom contains ample ventilation, age-appropriate toys, and furniture readily accessible for children in care. Children bring their own water bottles and facility also provides filter water for use. LPA observed all cleaning compounds, disinfectants, sharps, combustibles, and tools to be elevated and or locked, and inaccessible to children. LPA observed the facility has a sufficient number of restrooms and sinks available for the children. Facility provides one (1) snack during center hours and LPA observed kitchen to be clean, free of rodents, and appliances in working order. Fire extinguisher was last serviced on February 28th, 2023. Last emergency drill was conducted on 4/24/2023. Per teacher, no firearms or ammunition are present on property.

LPA observed the outdoor area play area to have ample amount of space for children, and appropriate toys and equipment. LPA observed soft padding, and sandbox free of debris. No bodies of water are present.

Incident Medical Services are not being provided at this time.

CONTINUED ON LIC809C

SUPERVISOR'S NAME: Ana TolentinoTELEPHONE: (805) 562-0347
LICENSING EVALUATOR NAME: Maryrose BreaultTELEPHONE: (805) 635-5097
LICENSING EVALUATOR SIGNATURE:
DATE: 05/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/23/2023
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: SBCEO - SANTA YNEZ VALLEY STATE PRESCHOOL
FACILITY NUMBER: 426207286
VISIT DATE: 05/23/2023
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A sampling of children and staff records were reviewed. Teachers have required qualifications. Pediatric First Aid/CPR certificate expires 8/8/2024 and AB 1207 Mandated Reporter Training certificate expires 8/7/2024. LPAs verified SB 792 Child Care Adult Immunization and Tuberculosis Requirements. LPA reminded teacher all personnel records shall be maintained at the childcare center for review.

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 follow 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

No deficiencies were cited during today’s inspection.

Technical assistance provided.

Exit interview conducted, report reviewed, and copy provided to teacher.

NOTICE OF SITE VISIT POSTED.

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

DATE: 05/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/23/2023
LIC809 (FAS) - (06/04)
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