566215048-10-7-2021-17-CC-FPEA-C7KVUQ-20211007164507

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 566215048
Report Date: 10/07/2021
Date Signed: 10/07/2021 04:45:13 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:	SOMIS COMMUNITY PRESCHOOL		FACILITY NUMBER:	566215048
ADMINISTRATOR:	NELLUM LEWIS		FACILITY TYPE:	850
ADDRESS:	3300 WEST STREET		TELEPHONE:	(805) 386-3176
CITY:	SOMIS	STATE: CA	ZIP CODE:	93066
CAPACITY:	46	CENSUS: 12	DATE:	10/07/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	02:35 PM
MET WITH:	Kim Couchman		TIME COMPLETED:	05:00 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 October 7, 2021 at 2:35 PM, Licensing Program Analyst (LPA) Francisco Pedroza conducted an unannounced Annual/Random inspection. LPA contacted the facility by phone and conducted Covid screening prior to entering the facility. LPA met with facility Interim Director Kim Couchman and advised her the purpose of the inspection. Director provided LPA a tour of the facility inside and out. There was 12 children in care at the time of the inspection. Facility operation hours are Monday - Friday 8:00 AM - 5:00 PM. LPA observed required licensing documents on the parents board located in the preschool office on the wall. LPA observed the center snack schedule. The center provides two (2) snacks daily for children. Children bring their own lunch from home. The center has four (4) classrooms available for use. They were only using two (2) classrooms at the time of the inspection. One (1) classroom is used for isolation. LPA observed three restrooms with enough sinks and toilets available for children in care. LPA did not observe any hazards/toxins items accessible to children in care. Each of the classrooms have age appropriate toys and furniture readily accessible for children in care. Facility provides children that are staying full day a sleeping mat during quiet time if they choose to sleep. The outdoor playground has an ample amount of space for children to play. LPA observed the playground has age appropriate toys and structures available for children to use. The playground has ample amount of shade available. The facility has water available for children inside and out. Facility has a local vendor delivering water for a water cooler located in the office. Each classroom has a water pitcher they fill to provide children water in small paper Dixie cups. Continued on 809-C

SUPERVISOR'S NAME: George Mingle	TELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Francisco Pedroza	TELEPHONE: (805) 689-4212
LICENSING EVALUATOR SIGNATURE:	DATE: 10/07/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2021

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: SOMIS COMMUNITY PRESCHOOL	FACILITY NUMBER: 566215048
	VISIT DATE: 10/07/2021

NARRATIVE

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A sampling of children and staff records were reviewed. LPA observed children's files to be complete and current. Currently the facility does not have children that require Incident Medical services (IMS). LPA observed staff files to be complete and current. LPA verified SB792 Child Care Adult Immunization and Tuberculosis requirements. Teachers meet the required qualifications. Teachers present have current Pediatric CPR/First-Aid certificates that are valid until 8/30/2023. Teachers have current Mandated Reporter certificates that are valid until 1/27/2023. LPA spoke with Director about new Covid-19 guidelines. Facility is not currently following Covid-19 guidelines. LPA observed children and teachers not wearing masks. Director was under the impression that it was recommended for children to wear masks not a requirement. LPA advised Director that staff and children over the age of two (2) years old must wear a face mask according the California Department of Public Health. California Department of Public Health "Guidance for the Use of Face Coverings" resource was provided.

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 follow 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

No deficiencies were cited during today's inspection.

THE NOTICE OF SITE VISIT WAS POSTED AS REQUIRED BY H&S CODE SEC. 1596.817.

SUPERVISOR'S NAME: George Mingle	TELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Francisco Pedroza	TELEPHONE: (805) 689-4212
LICENSING EVALUATOR SIGNATURE:	DATE: 10/07/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2021

LIC809 (FAS) - (06/04)

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