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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426211744
Report Date: 03/23/2023
Date Signed: 03/23/2023 03:51:27 PM


Document Has Been Signed on 03/23/2023 03:51 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 CENTERFACILITY NUMBER:
426211744
ADMINISTRATOR:ADRIANA RODRIGUEZFACILITY TYPE:
850
ADDRESS:1240 W. BETHEL LN. #1ATELEPHONE:
(805) 347-8400
CITY:SANTA MARIASTATE: CAZIP CODE:
93458
CAPACITY:72CENSUS: 16DATE:
03/23/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:37 PM
MET WITH:Jennifer SmithTIME COMPLETED:
04:00 PM
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On 10/21/2022, Licensing Program Analysts (LPA) Martina Jimenez, conducted an unannounced Case Management inspection to follow up on a report of an Unusual Incident Report (UIR) received by the Department on 3/17/2023.

LPAs met with Jennifer Smith, Lead Teacher, the purpose of the inspection was discussed. LPA tour the center with the lead teacher, LPA observed 16 children in care and 3 staff at the time of inspection.

LPA spoke with Jennifer Smith, Lead Teacher, in reference to the incident that occurred on 3/1/2023. The incident was found to have been appropriately handled by the center. The center will continue to monitor the children's behavior encourage safe play and go over safety rules throughout, the day, talking with staff, and children on safety play.

Based on observations and the interview with the Lead Teacher it is determined by LPA to be best categorized the incident as an accident.

There were no deficiencies cites at this time. FAILURE TO POST THE NOTICE OF SITE VISIT FOR 30 DAYS MAY RESULT IN A $100.00 CIVIL PENALTY.
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Martina JimenezTELEPHONE: (805) 387-5041
LICENSING EVALUATOR SIGNATURE:
DATE: 03/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/23/2023
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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