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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 406208351
Report Date: 07/09/2026
Date Signed: 07/09/2026 11:30:57 AM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 07/09/2026 11:30 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:CHILDREN'S ACADEMY MONTESSORI SCHOOL, THEFACILITY NUMBER:
406208351
ADMINISTRATOR/
DIRECTOR:		TAMERA DAVISFACILITY TYPE:
850
ADDRESS:711 ROLLING HILLS DRIVETELEPHONE:
(805) 239-9790
CITY:PASO ROBLESSTATE: CAZIP CODE:
93446
CAPACITY: 40TOTAL ENROLLED CHILDREN: 40CENSUS: 33DATE:
07/09/2026
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:50 AM
MET WITH:Tamera DavisTIME VISIT/
INSPECTION COMPLETED:
11:50 AM
NARRATIVE
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On 7/9/26, at 9:50 AM, Licensing Program Analyst (LPA) Matthew Sapien made an unannounced Case Management inspection at the abovementioned Child Care Center (CCC). LPA met with Tamera Davis, Director of the CCC and explained the nature and purpose of the inspection. LPA, in the company of the Director, toured the interior and exterior of the CCC. At the time of the inspection, LPA observed 33 children in care. In addition to the Director of the CCC, LPA also observed 5 additional staff members at the time of the inspection (cleared and associated). LPA also observed a 14 year old family friend helping with maintenance around the facility.

This Case Management inspection follows an Unusual Incident at the CCC which occurred on 6/24/26. On 7/3/26, it was reported to the Department via email. Importantly to note, the CCC's current hours of operation are Monday through Friday from 7:00 AM until 5:30 PM. From June to August annually, the CCC operates Monday through Friday from 8:00 AM until 4:30 PM.

Regarding the incident on 6/24/26, a child who is not enrolled at the CCC (C1), but helps with facility maintenance during the summer, brought a water gun to the facility. In one of the classrooms, C1 used the water gun to spray a classroom ceiling. Another child (C2), who is enrolled at the CCC and was nearby to C1, was directly underneath the ceiling from where the water was dripping from. C1 began filming C2 of the water falling onto the child. C1, at a later point, sent the video of C2 to C1's friends as a joke. C2 was confused about the incident which lasted a total of around 30 seconds. The video was later permanently deleted. Although not unsupervised, the incident took place during a group lesson when C2 was separate from their peers because they needed their own personal space.

Following the incident, the Director informed parents that have children in care and the Department that C1 will no longer work at the CCC while day care children are present. Director met with C2's parents to explain the incident on 7/3/26. Director gave a copy of the Unusual Incident Report (LIC 624) that was (CONT. 809-C, Page 2).

NAME OF LICENSING PROGRAM MANAGER: Maria Mueller
NAME OF LICENSING PROGRAM ANALYST: Matthew Sapien
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 07/09/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/09/2026
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: CHILDREN'S ACADEMY MONTESSORI SCHOOL, THE
FACILITY NUMBER: 406208351
VISIT DATE: 07/09/2026
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submitted to the Department and also provided an updated media consent form within child enrollment packets.

LPA reminded the Facility Representative of the importance of direct supervision over children in care at all times and the importance and deadlines of reporting requirements when it comes to reporting incidents.

During today's inspection, one Type B citation was issued (see LIC 809-D page).

A notice of site visit was given and must remain posted for 30 days. Appeal rights were also given and signature on this form acknowledges receipt of these rights. Exit interview was conducted and report was reviewed with the Site Supervisor, Tamera Davis.

NAME OF LICENSING PROGRAM MANAGER: Maria Mueller
NAME OF LICENSING PROGRAM ANALYST: Matthew Sapien
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/09/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2026
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 07/09/2026 11:30 AM - It Cannot Be Edited


Created By: Matthew Sapien On 07/09/2026 at 10:18 AM
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 ACADEMY MONTESSORI SCHOOL, THE
FACILITY NUMBER: 406208351

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/09/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/16/2026
Section Cited
CCR
101223(a)(2)

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101223(a)(2) - Personal Rights - (a) The licensee shall ensure that each child is accorded the following personal rights:...(2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs.
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Site Supervisor informed LPA that C1 will not be present on site during CCC operations. Site Supervisor will also submit a written plan of correction on or before 7/16/26 by the close of business day (5:00 PM). This written plan of correction will detail how such
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This requirement is not met as evidenced by...

Based on interview, C2 was left to be filmed by C1 when water was dripping onto C2 for the 30 second duration of the incident. C1 sprayed a water gun at the ceiling initially.
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by the close of business day (5:00 PM). Additions to the parent contract regarding media consent was also implemented.

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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.
Maria Mueller
NAME OF LICENSING PROGRAM MANAGER:
Matthew Sapien
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 07/09/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/09/2026


LIC809 (FAS) - (06/04)
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