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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426214456
Report Date: 07/21/2021
Date Signed: 07/21/2021 02:17:42 PM

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:GARDEN PRESCHOOLFACILITY NUMBER:
426214456
ADMINISTRATOR:ALAN R. STROUTFACILITY TYPE:
850
ADDRESS:305 EAST ANAPAMU STREETTELEPHONE:
(805) 451-5487
CITY:SANTA BARBARASTATE: CAZIP CODE:
93101
CAPACITY:47CENSUS: 30DATE:
07/21/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Devon RoblesTIME COMPLETED:
02:30 PM
NARRATIVE
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A case management inspection was conducted by Licensing Program Analysts (LPAs) S. Mendoza-Ceja and J. Laxo who met with the Co-Director Devon Robles. The purpose of the inspection was to review the incident that occurred on 06/16/2021. The Director reported the incident and submitted the incident report to the Department as required.

On 06/16/2021, the Pre-k and 3 year old classrooms were on the playground when an incident occurred. At approximately 4:35 pm, child #1's was running/chasing another child when child #1 tripped and fell landing on his left arm. Child #1's sustained an injury and teacher #1 contacted the parents immediately. Teacher #1 stated she administered first aid to child #1. Parents did seek medical attention for child #1 who sustained a broken arm.

Further review of the incident, revealed there were two aides supervising up to 13 children at the time of the incident. Teacher #1 stated she went to the restroom and when she returned to the playground area a few minutes later. When she returned to the playground is when aide #1 was walking up to her with child #1 who had already sustained the injury.

During the inspection, LPAs reviewed staff qualifications and interviewed staff.

The following Type B deficiencies are cited according to CCR, Title 22, Division 12 on page #2 and page #3.
Exit interview was conducted with Devon Robles, during which time Appeal Rights were explained.
Appeal Rights were reviewed.

Failure to Post the Notice of Site Visit for 30 days may result in a $100.00 Civil Penalty.
SUPERVISOR'S NAME: Ana TolentinoTELEPHONE: (805) 562-0437
LICENSING EVALUATOR NAME: Sylvia Mendoza-CejaTELEPHONE: (805) 722-5132
LICENSING EVALUATOR SIGNATURE:

DATE: 07/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2021
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: GARDEN PRESCHOOL
FACILITY NUMBER: 426214456
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/21/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/28/2021
Section Cited

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Teacher Child Ratio: There shall be a ratio of one teacher visually observing and supervising no more than 12 children in attendance, except as specified in (b) and (c) below.

This requirement was not met as evidenced by
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staff interviews and review of files revealed there were two aides supervising up to 13 children at the time of the incident. Teacher #1 stated she went to the restroom and when she returned to the playground area a few minutes later.
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Type B
07/28/2021
Section Cited

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On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following
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the date on which he or she completed the initial mandated reporter training. This requirement was not met as evidenced by review of records and interviews.

Review of records and interviews revealed staff 4 files reviewed did not have verification of current AB 1207 Training.
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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: Ana TolentinoTELEPHONE: (805) 562-0437
LICENSING EVALUATOR NAME: Sylvia Mendoza-CejaTELEPHONE: (805) 722-5132
LICENSING EVALUATOR SIGNATURE:
DATE: 07/21/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/21/2021
LIC809 (FAS) - (06/04)
Page: 2 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: GARDEN PRESCHOOL
FACILITY NUMBER: 426214456
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/21/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/28/2021
Section Cited

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Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.
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This requirement was not met as evidenced by review of records and interviews.

Review of records and interviews revealed staff 3 of 4 files reviewed did not have verification of MMR, Tdap and Flu.
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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: Ana TolentinoTELEPHONE: (805) 562-0437
LICENSING EVALUATOR NAME: Sylvia Mendoza-CejaTELEPHONE: (805) 722-5132
LICENSING EVALUATOR SIGNATURE:
DATE: 07/21/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/21/2021
LIC809 (FAS) - (06/04)
Page: 3 of 3