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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426207287
Report Date: 11/02/2022
Date Signed: 11/02/2022 11:45:53 AM

Document Has Been Signed on 11/02/2022 11:45 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 - LA HONDA STATE PRESCHOOLFACILITY NUMBER:
426207287
ADMINISTRATOR:JANELLE WILLISFACILITY TYPE:
850
ADDRESS:608 EAST CENTRAL AVENUETELEPHONE:
(805) 742-0433
CITY:LOMPOCSTATE: CAZIP CODE:
93436
CAPACITY: 26TOTAL ENROLLED CHILDREN: 26CENSUS: DATE:
11/02/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:36 AM
MET WITH:Evelyn Garcia TIME COMPLETED:
12:03 PM
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On November 2, 2022 @9:36 AM Licensing Program Analyst (LPA) Rona Chavez conducted an unannounced/required ANNUAL Inspection. LPA met with Site Supervisor Evelyn Garcia and explained the purpose of the inspection. The preschool has 2 half day sessions - Monday - Friday 8:00am - 11:00am and 12:00pm - 3:00pm. LPA and Site Supervisor toured inside and outside of the center. There were 15 children present and 3 staff providing care.

Facility has all required forms and documents posted at the entrance to the class room. LPA did not observe any toxins/hazardous items accessible to children. The class room has age appropriate furniture and toys available to the children in care. LPA observed a working Carbon Monoxide Detector installed in the classroom. Facility provides AM/PM snack and menu posted at the entrance. Facility uses an digital app CareConnect for sign in and sign out. The outdoor playground has an ample amount of space for children to play. LPA observed the playground has age appropriate toys and structures available for children to use. The playground has ample amount of shade available. The facility has bottled water and dispenser available for children inside and out.

A sampling of children and staff records were reviewed and found complete. Teachers have required qualifications. Teachers present have current Pediatric First Aid/CPR certificates that expire on 08/2023.

Continued on 809-C

SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Rona Chavez
LICENSING EVALUATOR SIGNATURE: DATE: 11/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/02/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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 - LA HONDA STATE PRESCHOOL
FACILITY NUMBER: 426207287
VISIT DATE: 11/02/2022
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Teachers present have current AB 1207 Mandated Reporter Training certificates that expire on 01/2024. LPA verified SB 792 Child Care Adult Immunization and Tuberculosis Requirements. The last fire drill was completed on 09/16/2022. Center is currently providing Incidental Medical Services (IMS).

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.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


To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

Site Supervisor 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
SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Rona Chavez
LICENSING EVALUATOR SIGNATURE:

DATE: 11/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/02/2022
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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 - LA HONDA STATE PRESCHOOL
FACILITY NUMBER: 426207287
VISIT DATE: 11/02/2022
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LPA discussed the safe sleep regulations with director and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

No deficiencies were cited during today's inspection.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100 if this regulation is violated.

A copy of this report and appeal rights were provided.

An exit interview was conducted with Evelyn Garca, Site Supervisor
SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Rona Chavez
LICENSING EVALUATOR SIGNATURE:

DATE: 11/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/02/2022
LIC809 (FAS) - (06/04)
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