401702661-1-23-2025--CC-MSAN-DD7Q5K-20250123105203

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 401702661
Report Date: 01/21/2025
Date Signed: 01/23/2025 10:53:08 AM

Document Has Been Signed on 01/23/2025 10:53 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME:	SAN MIGUEL EARLY LEARNING CENTER		FACILITY NUMBER:	401702661
ADMINISTRATOR/ DIRECTOR:			FACILITY TYPE:	850
ADDRESS:	1601 L STREET		TELEPHONE:	(805) 467-3626
CITY:	SAN MIGUEL	STATE: CA	ZIP CODE:	93451
CAPACITY: 0	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	01/21/2025
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	11:40 AM
MET WITH:	Ashley Mottard		TIME VISIT/ INSPECTION COMPLETED:	02:20 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 1/21/25, at 11:40 AM, Licensing Program Analyst (LPA) Matthew Sapien conducted an unannounced random inspection of the abovementioned Child Care Center (CCC). LPA met with Ashley Mottard, Interim Site Supervisor of the CCC, and explained the nature and purpose of the inspection. The LPA, in the company of the Interim Site Supervisor, toured the interior and exterior of the CCC. The CCC utilizes one classroom (the preschool classroom), two school bathrooms, and an outdoor play area. The CCC resides on the grounds of Lillian Larsen Elementary School. The CCC’s days of operation are Monday through Friday with two groups of children throughout the day. The CCC’s hours of operation for the morning group is from 8:00 AM until 11:00 AM, while the afternoon hours of operations are from 12:00 PM until 3:00 PM. Upon arrival, LPA observed 0 children in care, along with two staff assistants (cleared and associated). The preschool classroom was observed to be orderly and clean. The classroom has age-appropriate toys, books, and other furnishings for children in care. Upon arrival for both the morning and afternoon class, the CCC provides one snack for children in care. Interim Site Supervisor informed LPA available drinking water for children at the CCC is available via water bottles. Children also bring their filled and reusable water bottles from home so that the proper water amounts are being monitored and consumed. LPA observed one refrigerator in the CCC that contains classroom snacks, milk, and water. CCCs constructed before 1/1/20, are supposed to test their water (used for drinking and food preparation) for lead contamination before 1/1/23, and then every 5-years except after the date of the first test. For child care center licenses issued after 7/1/22, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP). LPA confirmed that the CCC is in compliance with the following directives. LPA reviewed the children's sign in and sign out forms and found the arrival (CONT. LIC 802-C)

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Matthew Sapien
LICENSING EVALUATOR SIGNATURE:	DATE: 01/21/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2025

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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: SAN MIGUEL EARLY LEARNING CENTER	FACILITY NUMBER: 401702661
	VISIT DATE: 01/21/2025

NARRATIVE

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times of children, along with the departure times at the entryway of the CCC. The signatures of authorized representatives were also present.

LPA observed one carbon monoxide detector within the CCC. A carbon monoxide detector was tested at 11: 53 AM. The detector was found to be operational. LPA also observed a fire extinguisher in the CCC. Interim Site Supervisor informed LPA that the CCC’s smoke alarm system is integrated. Cleaning compounds were observed in a cabinet beneath the sink, which is made secure by a child safety lock. Additional cleaning compounds were observed on top of a file cabinet near the teacher’s desk in an elevated position. Sharps (a knife) were also observed in securely locked cabinet. Scissors were also observed near the teacher’s desk in an elevated area. Additionally, medication was observed in a lockbox in an elevated and locked cabinet. A First Aid Kit was observed in different areas throughout the CCC.

As mentioned prior, the CCC utilizes 2 bathrooms, which is on the school grounds. There are total of 2 toilets in the girls bathroom and one toilet and urinal in the boys bathroom. The bathrooms were found to be clean, orderly, and rid of any hazardous items for children in care.

The outdoor play area is enclosed by metal chain linked fencing throughout. The fence’s entry/exit gates are secure and furnishings in the area are age appropriate. The play structures in the outdoor play area have adequate cushioning materials to absorb falls. The footing of the exterior is varied (concrete pavement, sand, and foam surfaces). In the outdoor area, shade is provided via building overhangs. In the outdoor play area, LPA observed 3 large sheds and 1 storage compartment. Interim Site Supervisor informed LPA that childcare equipment is solely stored in these units. Director attested that children are always supervised while outside and that the outdoor area is inspected prior to letting children outside.

A sampling of staff and children records were reviewed. The children’s records were complete and were found to contain emergency contact information as well admission agreements, among other relevant licensing documents and forms. Staff records were reviewed and contained current pediatric CPR and First Aid certifications (EMSA approved) and Mandated Reporter Training certificates. Facility records show the last fire drill on site occurred on 1/17/25. Interim Site Supervisor informed LPA that disaster drills are typically conducted on a monthly basis. LPA confirmed that there are no bodies of water, firearms, or ammunition that are stored on site. (CONT. 809-C, Page 3).

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Matthew Sapien
LICENSING EVALUATOR SIGNATURE:	DATE: 01/21/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2025

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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: SAN MIGUEL EARLY LEARNING CENTER	FACILITY NUMBER: 401702661
	VISIT DATE: 01/21/2025

NARRATIVE

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This facility does currently provide Incidental Medical Services – IMS. For IMS information see PIN 22-02-CCP. LPA confirmed that the CCC is in compliance with the following directives. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

Facility representative was reminded that all adults 18 and over, including employees and volunteers, as specified in HSC section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Facility representative was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

During today's visit, no deficiencies were issued. Director was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these rights.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Facility representative, Ashley Mottard.

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Matthew Sapien
LICENSING EVALUATOR SIGNATURE:	DATE: 01/21/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2025

LIC809 (FAS) - (06/04)

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