426211744-9-1-2022-17-CC-MJIZ-CHUT4D-20220901142346

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 426211744
Report Date: 09/01/2022
Date Signed: 09/01/2022 02:23:57 PM

Document Has Been Signed on 09/01/2022 02:23 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:	CAC - WESTGATE CENTER		FACILITY NUMBER:	426211744
ADMINISTRATOR:	ADRIANA RODRIGUEZ		FACILITY TYPE:	850
ADDRESS:	1240 W. BETHEL LN. #1A		TELEPHONE:	(805) 347-8400
CITY:	SANTA MARIA	STATE: CA	ZIP CODE:	93458
CAPACITY:	72	CENSUS: 28	DATE:	09/01/2022
TYPE OF VISIT:	Case Management - Other	UNANNOUNCED	TIME BEGAN:	01:35 PM
MET WITH:	Adriana Rodriguez		TIME COMPLETED:	02:40 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 September 1, 2022 at 1:35 PM, Licensing Program Analyst (LPA) Martina Jimenez conducted an unannounced Case Management – COVID-19 inspection and met with, Adriana Rodriguez, Site Supervisor. LPA informed the purpose for the inspection and completed a COVID-19 pre-screening questions prior to the commencement of the inspection. The Site Supervisor gave LPA a tour of the facility, inside and outside. This inspection is a follow-up on COVID-19 outbreaks reported by facility staff to CCL between August 11, 2022 - August 31, 2022. CCL provided a Tele - Rapid Assistance Support Team (RAST) inspection on April 6, 2021, where LPA provided COVID-19 resources, current Childcare Industry Guidance, and a COVID-19 self-assessment guide to the facility. LPA observed facility staff wearing masks upon arrival to the facility. The children in care were napping during this inspection. This report continues on LIC 809C

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Martina Jimenez	TELEPHONE: (805) 387-5041
LICENSING EVALUATOR SIGNATURE:	DATE: 09/01/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/01/2022

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: CAC - WESTGATE CENTER	FACILITY NUMBER: 426211744
	VISIT DATE: 09/01/2022

NARRATIVE

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LPA discussed facility’s written plan for when a staff member or child tests positive for COVID-19 and developing a written communication plan with parents/guardians to share information and guidelines in their preferred language.

LPA discussed COVID-19 Vaccines, Testing, Face coverings, Essential Protective Equipment and Supplies, Physical Distancing, Ventilation, Isolation for Illness, Cleaning and Disinfection, Hand-washing, Food Service and Meal Times.

LPA reviewed that facility maintains a current Covid-19 Child Care Program Self-Assessment Guide/Mitigation plan. LPA also provided the following resources:

- Official Public Health and Child Care Guidance for COVID-19 – Updated 1/26/2022.

- COVID-19 Child Care Resources:
https://www.cdss.ca.gov/inforesources/cdss-programs/community-care-licensing/child-care-licensing/covid-19-child-care-resources

There were no deficiencies 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.

Exit interview conducted and report was reviewed with the Site Supervisor, Adriana Rodriguez.

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Martina Jimenez	TELEPHONE: (805) 387-5041
LICENSING EVALUATOR SIGNATURE:	DATE: 09/01/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/01/2022

LIC809 (FAS) - (06/04)

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