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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426207378
Report Date: 07/13/2022
Date Signed: 07/13/2022 10:56:55 AM

Document Has Been Signed on 07/13/2022 10:56 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:CAC - CHESTNUT TODDLER CENTERFACILITY NUMBER:
426207378
ADMINISTRATOR:MARIA CERVANTESFACILITY TYPE:
850
ADDRESS:120 W. CHESTNUT AVE.TELEPHONE:
(805) 740-4555
CITY:LOMPOCSTATE: CAZIP CODE:
93436
CAPACITY: 20TOTAL ENROLLED CHILDREN: 20CENSUS: 6DATE:
07/13/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Maria CervantesTIME COMPLETED:
11:00 AM
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On 7/13/22, at 8:30 AM, Licensing Program Analyst (LPA) Elvin Baddley conducted an unannounced One Year Required inspection of the abovementioned Child Care Center (CCC). LPA met with Maria Cervantes, Site Supervisor of the CCC, and explained the purpose of the inspection. LPA, in the company of the Site Supervisor toured the interior and exterior of the CCC. The CCC is a preschool program with a toddler component. The CCC consist of two rooms (Room A and Room B) and a shared outdoor play area. The CCC's hours of operation are from 7:15 AM to 5:15 PM, Monday - Friday. During the inspection, LPA observed six children in care, along with four teachers providing supervision. LPA notes all staff members were wearing face covering during inspection. Children in care are awake and involved in various activities.

The rooms used for child care services are clean, orderly and free of hazards. The two room of the CCC mirror each other in appearance. Rooms have ample storage space ("cubbies") for all children in care and age appropriate furnishings, toys and equipment. LPA observed carbon monoxide detectors in each of the CCC's rooms. A detector in Room B was tested at 9:10 AM and found to be operable. Disinfectants and cleaning solutions are stored in an elevated cabinet in the CCC's rooms and within the kitchen area which is inaccessible to children in care. Sharps are also stored locked drawers and secure elevated cabinets in rooms. Medications is secured in a cabinet in the CCC's kitchen area as well.

The CCC has an operable refrigerator in the kitchen which contains food items consumed by the CCC's children. Items in the refrigerator are labeled and dated. The CCC provided snacks, breakfast and lunch to children in care. There is available filtered drinking water for children inside and outside. The CCC has no water fountains on site. Site Supervisor is informed of requirement to have the CCC's water sources lead tested. LPA observed a menu posted in the rooms along with required notices and documents posted on room's walls.. LPA reviewed CCC Sign In/Out forms and notes the forms reviewed are completed appropriately, having the authorized parent's signature as well as entry and exit times.
(CONT. 809-C)
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE: DATE: 07/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/13/2022
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: CAC - CHESTNUT TODDLER CENTER
FACILITY NUMBER: 426207378
VISIT DATE: 07/13/2022
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The restroom of the CCC are observed to be clean and void of toxins. Waste receptacles at the CCC are observed to have tight fitting lids and changing tables are within arms length of a sink.

The outdoor play area is enclosed and the fence’s entry/exit gates are secured. Furnishings in the area are age appropriate. LPA observed a shed in the outdoor play area which contained CCC supplies and equipment. The shed was secured. The play structures in the outdoor play area have adequate cushioning materials to absorb falls. Shade is provided by a tree in the area as well as building overhangs. LPA reminded Site Supervisor to replace outdoor equipment which begin to degrade and is not of good repair. .

Staff and children records were reviewed. The children’s records were complete and found to contain emergency contact information as well as immunization records. LPA also reviewed the documentation of children's sleep in interval of 15 minutes. Staff records were reviewed and contained current pediatric CPR and First Aid certifications (EMSA) along with Mandated Reporter certifications. Site Supervisor notes no firearm or ammunition is stored on site. Additionally the last fire/disaster drill which occurred at the CCC took place on 6/24/22.

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

LPA discussed the safe sleep regulations with Facility Representative 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 for additional resource. LPA also informed Facility Representative 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.

Facility Representative was reminded that all adults 18 and over, including employees and volunteers, must
(CONT. 809-C)
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE:

DATE: 07/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2022
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: CAC - CHESTNUT TODDLER CENTER
FACILITY NUMBER: 426207378
VISIT DATE: 07/13/2022
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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 Maria Cervantes
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE:

DATE: 07/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2022
LIC809 (FAS) - (06/04)
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