401710487-12-6-2022-17-CC-EBAY-CLUS8T-20221206123940

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 401710487
Report Date: 12/06/2022
Date Signed: 12/06/2022 12:39:46 PM

Document Has Been Signed on 12/06/2022 12:39 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:	NEW LIFE COMMUNITY CHURCH OF THE NAZARENE		FACILITY NUMBER:	401710487
ADMINISTRATOR:	COURTNEY CROSSON		FACILITY TYPE:	850
ADDRESS:	990 JAMES WAY		TELEPHONE:	(805) 489-3575
CITY:	PISMO BEACH	STATE: CA	ZIP CODE:	93449
CAPACITY: 78	TOTAL ENROLLED CHILDREN: 78	CENSUS: 54	DATE:	12/06/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:45 AM
MET WITH:	Courtney Crosson		TIME COMPLETED:	12:45 PM

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On 12/5/22, at 9:45 AM, Licensing Program Analyst (LPA) Elvin Baddley conducted an unannounced One Year Required Inspection the abovementioned Child Care Center (CCC). The LPA met with Courtney Crosson, Director of the CCC and explained the purpose of the inspection. The LPA, in the company of the Director, toured the interior and exterior of the CCC. The CCC operates from 7:30 AM to 5:30 PM, Monday - Friday. The CCC uses seven classrooms (Classroom 1- ages 2, Classroom 2- ages two and three, Classroom 4- ages three, Classroom 5- ages 3, Classroom 6- ages 3, Classroom 7- Pre Kindergarten and Classroom 8 - Pre Kindergarten) for care. During the inspection, LPA observed 54 children on site along with 9 teachers (cleared and associated) providing care and supervision.

The classrooms of the CCC were observed to be orderly, clean and organized. All classrooms have age appropriate toys and furnishings available for children in care. The CCC has carbon monoxide detectors throughout the CCC. A carbon monoxide detector was tested in Classroom 2 at 10:45 AM and found to be operable. All restrooms at the CCC were observed to be in safe and sanitary operating condition. LPA observed operable refrigerator in each classroom. The main refrigerator is located in the rear of Classroom 2. Food items in the refrigerator were labeled and dated. LPA notes snacks are provided by the CCC, while children in care bring lunches from their homes. The CCC reminds parent to provide healthy lunches for children in care which contain the essential food groups. There is available filtered drinking water for children both inside the classroom and outside in the play area. The CCC has never used build water sources for consumption or the washing of foods items. LPA reminded the Director of the need to test the facility's water sources for lead containments. LPA reviewed posted licensing required notices, forms and documents near the entry of each classroom. Likewise, sign In/out forms which are placed at the entry of the classrooms were reviewed by the LPA. The aforementioned contains the arrival and departure times of children in care along with the signature of authorized representatives.

Disinfectants, cleaning solutions, sharps and medications are observed in elevated locations in each classroom. The locations are beyond the reach of children in care and inaccessible.

(CONT. LIC 809-C, Page 2)

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE:	DATE: 12/06/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/06/2022

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: NEW LIFE COMMUNITY CHURCH OF THE NAZARENE	FACILITY NUMBER: 401710487
	VISIT DATE: 12/06/2022

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The CCC has three outdoor playground areas with varied footing. Each playground is enclosed by iron rod fencing. The fences' entry/exit gates are secured. LPA observed age appropriate toys and play equipment in each of the the play areas. The toys and play equipment observed are in suitable condition and free of sharp, loose or pointed objects. The play structures in the playground areas have adequate cushioning materials to absorb falls and an abundance of shade created by trees and building overhangs. No bodies of water were observed on site, however LPA observed a man made miniature creek which was empty. Director informed LPA the aforementioned is filled on occasions and drained after use. Further, Director stated children are directly supervised when the miniature creek in filled.

A sampling of staff and children's records are reviewed. The children’s records were complete and found to contain emergency contact information as well as immunization records. Staff member's records were reviewed and contained current CPR and First Aid certifications and well as Mandated Reporter certifications. Director informed LPA no firearm or ammunition is stored on site.

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

Facility representative is 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.

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 Courtney Crosson

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE:	DATE: 12/06/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/06/2022

LIC809 (FAS) - (06/04)

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