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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 401710471
Report Date: 08/08/2024
Date Signed: 08/08/2024 09:45:56 AM

Document Has Been Signed on 08/08/2024 09:45 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
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:C.L. SMITH SCHOOLFACILITY NUMBER:
401710471
ADMINISTRATOR/
DIRECTOR:		VALERIE BADAFACILITY TYPE:
840
ADDRESS:1375 BALBOATELEPHONE:
(805) 781-7447
CITY:SAN LUIS OBISPOSTATE: CAZIP CODE:
93401
CAPACITY: 65TOTAL ENROLLED CHILDREN: 65CENSUS: 0DATE:
08/08/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Michelle RolleTIME VISIT/
INSPECTION COMPLETED:
10:00 AM
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On 8/8/24, at 9:00 AM, Licensing Program Analyst (LPA) Elvin Baddley conducted an unannounced Case Management inspection (Licensee Initiated) of the abovementioned Child Care Center (CCC) as the CCC is requesting permission to relocate to another classroom within the same property/elementary school. LPA note the CCC operates out of a module classroom on the grounds of C.L. Smith Elementary School. LPA met with Michelle Rolle, Administrator of the CCC, and explained nature and purpose of the inspection. LPA notes no children are present during today's inspection.

LPA, in the company of Administrator, toured the interior and exterior of the CCC, as well as the proposed relocation classroom. The proposed relocation classroom, Room 12, is also on the grounds of C.L. Smith Elementary School. The CCC planned to relocate to Room 12 for the fall of 2024 school year which is set to commence on 8/15/24.

LPA observed Room 12 two have two exits and accommodations to support child care services. Room 12 has running water, a carbon monoxide detector and centralized air conditioning. Age appropriate furnishing and equipment are being moving into the classroom from the prior CCC. The CCC is in proximity to restrooms for children in care are well as an outdoor play area. CCC is planning to use the existing outdoor play area. Administrator is reminded to ensure child in care are not accessing play structures which are not age appropriate.

The proposed room is larger in scale than the existing room used for child care services. As such, Room 12 is feasible to support child care service. The CCC is granted permission to relocation to Room 12 at the commencement of the 2024 Fall school year (8/15/24).

No deficiencies have been cited during today's visit. A Notice of Site Visit (LIC 9213) and Appeal Rights (LIC 9058) are given to Administrator. The Notice of Site Visit must remain posted for 30 days or a civil (CONT. 809-C, Page 2)
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE: DATE: 08/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/08/2024
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 2
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: C.L. SMITH SCHOOL
FACILITY NUMBER: 401710471
VISIT DATE: 08/08/2024
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penalty of $100 may apply.

Exit interview conducted and report was reviewed with the Facility representative, Michelle Rolle.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE:

DATE: 08/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2024
LIC809 (FAS) - (06/04)
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