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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 401710899
Report Date: 09/23/2026
Date Signed: 09/23/2026 04:08:33 PM

Document Has Been Signed on 09/23/2026 04:08 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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:DEL MAR ELEMENTARY SCHOOL - KID'S CLUBFACILITY NUMBER:
401710899
ADMINISTRATOR/
DIRECTOR:		ANGELICA GALLARDOFACILITY TYPE:
840
ADDRESS:501 SEQUOIA, ROOM 25TELEPHONE:
(805) 772-6278
CITY:MORRO BAYSTATE: CAZIP CODE:
93442
CAPACITY: 50TOTAL ENROLLED CHILDREN: 50CENSUS: 22DATE:
09/23/2026
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:23 PM
MET WITH:Angelica GallardoTIME VISIT/
INSPECTION COMPLETED:
04:25 PM
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On September 23, 2026, Licensing Program Analysts (LPAs) Elizabeth George and Bill Billones conducted a case management inspection to review the facility’s request to change the designated classroom for the school-age program. The director reported that the school-age children will be relocated from their current classroom to a temporary space within the facility during the course of construction. LPA Billones received documentation from the Director on 9/18/26 regarding the classroom change. Proposed completion of classroom is Spring 2027.

LPAs were informed that the previous school-age classroom has been demolished, and a permanent building is currently under construction to replace it. While construction is ongoing, the facility has identified an alternative classroom (RM 24) to temporarily accommodate the school-age children. Facility staff shall ensure that the temporary classroom continues to meet all applicable Title 22 regulations throughout the duration of the relocation.

During the inspection, LPAs observed ants within the temporary classroom, including around and on top of a trash can. LPAs advised the director that the area must remain free of pests and that immediate cleaning and pest‑control measures are required. In addition, trash cans located outside must have fitted lids to prevent pest attraction and maintain sanitation standards.



LPAs inspected the proposed classroom and verified that the space meets Title 22 requirements for school-age children, including adequate square footage, age-appropriate furnishings, appropriate materials, and proper visibility for supervision. The classroom was observed to be clean, organized, and free of hazards. Required documents were posted within the classroom.

continued on LIC809-C

Ana Tolentino
Elizabeth George
DATE: 09/23/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/23/2026
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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: DEL MAR ELEMENTARY SCHOOL - KID'S CLUB
FACILITY NUMBER: 401710899
VISIT DATE: 09/23/2026
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The director stated that the temporary relocation is necessary to ensure continuity of care and program operations while the new permanent structure is being built.

LPAs advised the director that any future changes affecting indoor or outdoor space, including completion of the new building, must be reported to the Department prior to use.

At this time, the temporary classroom change for the school-age program is approved.

No deficiencies were cited at this time.

Exit interview was conducted and report was reviewed with director, Angelica Gallardo.

NAME OF LICENSING PROGRAM MANAGER: Ana Tolentino
NAME OF LICENSING PROGRAM ANALYST: Elizabeth George
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/23/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/23/2026
LIC809 (FAS) - (06/04)
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