426216159-5-13-2022-17-CC-GRES-CEDTMS-20220513145137

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 426216159
Report Date: 05/13/2022
Date Signed: 05/13/2022 03:47:17 PM

Document Has Been Signed on 05/13/2022 03:47 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:	SMBSD - ARELLANES PREKINDERGARTEN		FACILITY NUMBER:	426216159
ADMINISTRATOR:	RAQUEL VALDEZ		FACILITY TYPE:	850
ADDRESS:	1890 SANDALWOOD DR		TELEPHONE:	(805) 928-1783
CITY:	SANTA MARIA	STATE: CA	ZIP CODE:	93455
CAPACITY:	24	CENSUS: 12	DATE:	05/13/2022
TYPE OF VISIT:	Post Licensing	UNANNOUNCED	TIME BEGAN:	09:55 AM
MET WITH:	Raquel Valdez, Ana Hernandez		TIME COMPLETED:	02:52 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 May 13, 2022, Licensing Program Analyst (LPA) Gigi Reyes conducted an unannounced Post Licensing Inspection met with Site Supervisor Ana Hernandez and Teacher Miriam De Orozco. LPA explained the purpose of the inspection. Prior to inspection LPA asked screening questions related to COVID -19 and responses indicate there are no COVID 19 exposure on site. The Child Care Center is located at Arellanes Elementary School. The CCC operates two sessions, 8:00 AM to 11:00 AM and 11:45 AM to 2:45 PM LPA in the company of Ms. Hernandez toured the Center inside and out. There were 12 day care children and 3 staff present. Licensing required forms were posted in the wall. The school provides breakfast for morning class and lunch for afternoon session. The center shares the playground with kindergartners on a staggered schedule. The outdoor playground is enclosed with the wire fences, It has age appropriate toys and equipment. The playground has an ample amount cushioning. The center has water available for children inside and out. Center uses written sign-in/out logs at the entrance of the elementary school gate. A sampling of children and staff records were reviewed. Teachers have required qualifications. Teachers present have current Pediatric First Aid/CPR certificates that expire on 8/10/2023 Teachers present have current AB 1207 Mandated Reporter Training certificates that expire on 5/2/2024. Facility is following current Covid-19 guidelines. On or about 12:45 PM LPA left the CCC to proceed to Santa Maria Bonita School District Office to review additional confidential staff file located at the SMBSD Human Resources Office. LPA verified SB 792 Child Care Adult Immunization record and tuberculosis requirements.

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi Reyes	TELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:	DATE: 05/13/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/13/2022

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: SMBSD - ARELLANES PREKINDERGARTEN	FACILITY NUMBER: 426216159
	VISIT DATE: 05/13/2022

NARRATIVE

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No deficiencies were cited during today's visit. Technical Assistance and Technical Violation were issued.

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

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

Director was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA Reyes reviewed the report with the Program Director, Ms. Raquel Valdez who holds the office at SMBSD Office.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Program Director.

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi Reyes	TELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:	DATE: 05/13/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/13/2022

LIC809 (FAS) - (06/04)

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