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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 406205649
Report Date: 08/23/2021
Date Signed: 08/24/2021 05:09:14 PM

Document Has Been Signed on 08/24/2021 05:09 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:CHILDREN'S GARDEN, THEFACILITY NUMBER:
406205649
ADMINISTRATOR:GINA GOETSCHFACILITY TYPE:
840
ADDRESS:701 CROCKER ST.TELEPHONE:
(805) 434-1188
CITY:TEMPLETONSTATE: CAZIP CODE:
93465
CAPACITY: 30TOTAL ENROLLED CHILDREN: 30CENSUS: 0DATE:
08/23/2021
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
01:01 PM
MET WITH:Jeanne Hunt and Gina GoetschTIME COMPLETED:
01:31 PM
NARRATIVE
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On 8/23/2021, Licensing Program Analyst (LPA) Gigi Reyes conducted an unannounced Case Management Inspection, and met with Licensee Jeanne Hunt and Director Gina Goetsch. Prior to inspection LPA asked pre screening questions related to COVID 19, Director responses indicate there was no COVID exposure on site. The Center is closed for annual clean up and will resume its operation on 8/24/2021. There were 5 staff present and there were no children present during the inspection.

During the inspection, five (5 ) children's files were randomly reviewed. It was observed that LIC 9224 Acknowledgement of Receipt of Licensing Report with Type A Citation was not on file.

During today's inspection deficiency was cited under Health and Safety Code 1596.8595(c)(1) on the attached 809 D Appeal Rights Given.

Exit interview was conducted with Director Gina Goetsch.Notice of Site Visit has been posted (LIC9213). The notice shall be posted for 30 consecutive days. Failure to maintain posting as required will result in a $100.00 civil penalty. Web site address to obtain forms, review quarterly updates, review Title 22 & Health & Safety Codes is: https://www.cdss.ca.gov/inforesources/child-care-licensing
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE: DATE: 08/23/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/23/2021
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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Document Has Been Signed on 08/24/2021 05:09 PM - It Cannot Be Edited


Created By: Gigi Reyes On 08/23/2021 at 12:55 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: CHILDREN'S GARDEN, THE
FACILITY NUMBER: 406205649

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/23/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/30/2021
Section Cited
HSC
1596.8595(c)(1)

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(c)(1) A licensed child day care facility shall provide to the parents or guardians of each child receiving services in the facility copies of any licensing report that documents any Type A citation that represents an immediate risk to the health, safety, or personal rights of children in care as set forth in paragraph (1) of subdivision (a) of Section 1596.893b
This requirment is bnot met as evidence by:
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Director agreed to provide copies of this licensing report to each parent/guardian of enrolled children and to parents/guardians of newly enrolled children during the next 12 months. Plan of correction letter will be submitted to CCLD no later 8/30/2021.
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LPA review of children's record revealed that Type A Evaluation Report issued on 8/3/2021 was not provided to parents and LIC 9224 (Acknowledgement Form) was not in the children's file. This poses a potential risk to health and safety of chidlren in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Maria Mueller
LICENSING EVALUATOR NAME:Gigi Reyes
LICENSING EVALUATOR SIGNATURE:
DATE: 08/23/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/23/2021


LIC809 (FAS) - (06/04)
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