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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426214480
Report Date: 01/14/2020
Date Signed: 01/14/2020 12:21:00 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:SBCEO - LOMPOC CAL-SAFEFACILITY NUMBER:
426214480
ADMINISTRATOR:JANELLE WILLISFACILITY TYPE:
830
ADDRESS:320 NORTH "J" STREETTELEPHONE:
(805) 742-3134
CITY:LOMPOCSTATE: CAZIP CODE:
93436
CAPACITY:7CENSUS: 7DATE:
01/14/2020
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
10:50 AM
MET WITH:Mary Miller and Marisol CortezTIME COMPLETED:
12:00 PM
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Licensing Program Analyst (LPA) Ruth Gull made an unannounced RANDOM ANNUAL inspection to the center. Met with Mary Miller and Marisol Cortez, teachers and explained the purpose of the visit. Cecilia Vang, Site Supervisor was away from the center. This is a combination Infant and Preschool program which is funded by the State Department of Education and operates under Title 5. The center operates Monday - Friday from 7:45am to 4:30pm. A tour of the center was made both inside and outside. There are age appropriate toys/furnishings. There is a changing table and bathroom in the classroom. The posted menu was reviewed. LPA did not observe any toxins/hazardous items accessible to children. The outdoor area has shade, age appropriate toys/equipment. LPA reviewed a sampling of Individual needs & services plans and feeding plans, as well as children and staff records. LPA reviewed parent sign in/out sheets. All of the staff present have current Pediatric 1st Aid/CPR certificates (EMSA approved) valid until at least 07/2020. 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. Program Director previously submitted an IMS Plan of Operation.

Ms. Miller and Ms. Cortez were reminded that it is their responsibility to know the Child Care Center regulations which can be accessed online at www.ccld.ca.gov. LPA reviewed and provided Ms. Miller and Ms. Cortez with A Guide to Safe Sleep for Infants and a pamphlet regarding Effects of Lead Exposure (to be provided to both current and future parents).

There were no deficiencies cited in the areas inspected. The LIC 9213 (Notice of Site Visit) was posted.
SUPERVISOR'S NAME: Ana TolentinoTELEPHONE: (805) 562-0437
LICENSING EVALUATOR NAME: Ruth GullTELEPHONE: (805) 895-4073
LICENSING EVALUATOR SIGNATURE:

DATE: 01/14/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/14/2020
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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