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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426215049
Report Date: 10/28/2019
Date Signed: 10/28/2019 01:39:16 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:WALDORF SCHOOL OF SANTA BARBARA, THEFACILITY NUMBER:
426215049
ADMINISTRATOR:CAROLYN KASTERFACILITY TYPE:
850
ADDRESS:7421 MIRANO DRIVETELEPHONE:
(805) 967-6656
CITY:GOLETASTATE: CAZIP CODE:
93117
CAPACITY:60CENSUS: 18DATE:
10/28/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
11:25 AM
MET WITH:Carolyn KasterTIME COMPLETED:
01:45 PM
NARRATIVE
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An annual review was conducted by LPA S. Mendoza-Ceja who met with Carolyn Kastner who escorted LPA to the preschool. The center operates in classrooms #14 and #15, classroom #13 is also available, but not being used at this time. The preschool was toured inside and outside. LPA was advised the center does not administer medication. The classrooms were observed to be clean and orderly. The appropriate documents were posted for parent review. LPA reviewed the handouts “A Child Care Provider’s Guide to Safe Sleep, Safe Sleep Child Care, and Effects of Lead Exposure” and provided copies. The restrooms were inspected and observed to clean. The outside playground equipment was observed to be age appropriate. A random review was conducted of children's records. Staff records were reviewed. LPA reviewed CPR and First Aid expires 10/2019. The center has scheduled CPR and First Aid training for staff 11/1/2019.
LPA reviewed the requirement for care providers/employees, including volunteers to obtain immunization against Influenza, Pertussis, and Measles. LPA also discussed the requirement to complete AB 1207 Child Abuse Mandated Reporter Training.

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

The following Type B deficiencies are cited according to CCR, Title 22, Divsion 12 in regards to record keeping requirements. Appeal Rights provided.

SUPERVISOR'S NAME: Ana TolentinoTELEPHONE: (805) 562-0437
LICENSING EVALUATOR NAME: Sylvia Mendoza-CejaTELEPHONE: (805) 722-5132
LICENSING EVALUATOR SIGNATURE:

DATE: 10/28/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2019
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: WALDORF SCHOOL OF SANTA BARBARA, THE
FACILITY NUMBER: 426215049
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/28/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/18/2019
Section Cited

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Personnel Records: Documentation of the educational background, training and/or experience specified in this chapter.
A health screening as specified in Section 101216(g)

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The above regulation was not met as evidenced by the failure to have verification of staff #1's transcripts and physicals for staff #1, staff #3, and staff #4. This poses a potential risk to the safety of the children.
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Type B
11/18/2019
Section Cited

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Health and Safety - Employees or volunteers at day care center; immunization requirements; records; exemption: 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 the record review and interview which revealed staff #1 and staff #4 did not have verification of immunizations which poses a potential health and safety risk to children in care.

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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: 10/28/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/28/2019
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: WALDORF SCHOOL OF SANTA BARBARA, THE
FACILITY NUMBER: 426215049
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/28/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/18/2019
Section Cited

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 Health and Safety - Child Abuse Mandated Reporter Training: 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 the date on which he or she completed the initial mandated reporter training.



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This requirement was not met as evidenced by the record review and interview which revealed staff have not completed the training which poses a potential health and safety risk to children in care
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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: 10/28/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/28/2019
LIC809 (FAS) - (06/04)
Page: 3 of 3