426207603-1-4-2023-17-CC-GRES-CMRULF-20230104144040

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 426207603
Report Date: 01/04/2023
Date Signed: 01/04/2023 02:40:46 PM

Document Has Been Signed on 01/04/2023 02:40 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:	UPWARD BOUND PRE-SCHOOL		FACILITY NUMBER:	426207603
ADMINISTRATOR:	DEBORAH MADISSON		FACILITY TYPE:	850
ADDRESS:	1040 PATTERSON RD.		TELEPHONE:	(805) 938-5121
CITY:	SANTA MARIA	STATE: CA	ZIP CODE:	93455
CAPACITY:	60	CENSUS: 20	DATE:	01/04/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Deborah Madisson		TIME COMPLETED:	02:45 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On January 4, 2023, 11:00 AM, Licensing Program Analyst (LPA) Gigi Reyes conducted an unannounced 1 Year Required Inspection met with Director Ms. Deborah Madisson. LPA explained the purpose of the inspection. LPA asked pre screening questions related to COVID -19 and responses indicate there are no COVID-19 exposure on site. The Child Care Center (CCC) is operates Monday to Friday, from 7:00 AM to 5:15 PM. LPA in the company of Ms. Madisson toured the Center inside and out. The Center occupies 2 buildings, Building 1 and Building 2. There were 20 day care children and 4 staff present. Licensing required forms are posted in the wall. The current snack menu is also posted. The CCC provides snacks to day care children. The outdoor playground is enclosed with the wire fences and cinder block wall. It has age appropriate toys and equipment. The playground has an ample amount wood chip cushioning. The CCC has drinking water available for children inside and out. Director stated that CCC has not tested their drinking water for lead and water test is scheduled on 1/11/2023. Center uses a paper sign in /sign out and was found complete. A sampling of children and staff records were reviewed. Director's and Teachers' educational qualifications were verified. Teachers present have current Pediatric First Aid/CPR certificates that expire on 11/2024. All staff have taken the Mandated Reporter Training per AB 1207 and expire on 9/7/2024. Facility is following current Covid-19 guidelines. LPA verified the staff SB 792 Child Care Adult Immunization record and tuberculosis requirements. Continued on LIC 809C

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi Reyes	TELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:	DATE: 01/04/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/04/2023

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: UPWARD BOUND PRE-SCHOOL	FACILITY NUMBER: 426207603
	VISIT DATE: 01/04/2023

NARRATIVE

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During today's inspection, deficiency was cited under Health and Safety Code

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

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.

Director 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. Appeal rights were given and explained.

Exit interview conducted and report was reviewed with Director, Ms. Madisson.

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi Reyes	TELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:	DATE: 01/04/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/04/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 01/04/2023 02:40 PM - It Cannot Be Edited

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: UPWARD BOUND PRE-SCHOOL	FACILITY NUMBER: 426207603
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/04/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1597.16(a)(1)

§1597.16 (a) (1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on interview and record review the licensee did not comply with the section cited above, the CCC has not tested its drinking water for lead contamination as of 1/4/2023 which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 01/13/2023
	Plan of Correction
1 2 3 4	Director stated drinking water lead test is scheduled on 1/11/2023 which is the soonest date they could avail. Licensee will submit the plan of correction to Community Care Licensing (CCL) no later than 1/13/2023.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi Reyes	TELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:	DATE: 01/04/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/04/2023

LIC809 (FAS) - (06/04)

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