<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 406213418
Report Date: 03/05/2025
Date Signed: 03/05/2025 12:45:08 PM

Document Has Been Signed on 03/05/2025 12:45 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:CAPSLO - CUESTA HEAD START - RM 4011FACILITY NUMBER:
406213418
ADMINISTRATOR/
DIRECTOR:		ADRIANA BARRONFACILITY TYPE:
850
ADDRESS:4000 CHORRO VALLEY RD.TELEPHONE:
(805) 546-3100
CITY:SAN LUIS OBISPOSTATE: CAZIP CODE:
93405
CAPACITY: 20TOTAL ENROLLED CHILDREN: 20CENSUS: 9DATE:
03/05/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:00 AM
MET WITH:Penny GlassTIME VISIT/
INSPECTION COMPLETED:
12:00 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 3/5/25, at 11:01 AM, Licensing Program Analyst (LPA) Shane Loftus conducted an unannounced Annual/Random inspection of the above-mentioned Child Care Center (CCC). The LPA met with Penny Glass, Site Supervisor of the CCC and explained the purpose of the inspection. LPA, in the company of the Site Supervisor toured the interior and exterior of the CCC. The CCC operates on the grounds of Cuesta College's Children's Center Room 4011 from 8:00 AM to 4:30 PM, Monday - Friday. At the time of the inspection, LPA observed 9 children present, along with 3 teachers (cleared and associated) proving care and supervision.

The CCC is clean and organized. LPA observed age-appropriate toys and furnishings throughout the CCC. LPA observed a carbon monoxide detector in the CCC which was tested at 11:15 AM and found to be operable. The CCC's bathroom is in sanitary operating condition. The CCC has an operable refrigerator. LPA notes the CCC provides snacks, breakfast, and lunches for children in care. LPA observed a facility menu posted along with required licensing forms, documents, and notices. Disinfectants and cleaning solutions are stored in secure cabinets in the classroom. Additionally, medication in the facility is stored in a secure elevated location in the CCC which is beyond the reach of children in care. Sharps are stored in the kitchen of the CCC, which is inaccessible to children in care. LPA observed Sign In/Out forms near the CCC's entry. LPA notes the forms contain the child's arrival and departures as well as the signature of the authorized representatives. The CCC provides the children in care bottled/filtered water both inside the facility and in the outdoor activity area.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1- CCP). LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Shane Loftus
LICENSING EVALUATOR SIGNATURE: DATE: 03/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/05/2025
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 3
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: CAPSLO - CUESTA HEAD START - RM 4011
FACILITY NUMBER: 406213418
VISIT DATE: 03/05/2025
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
The CCC's outdoor play area has varied footing and is enclosed by chain link fencing. Entry/exit gates are secured. LPA observed sheds (two) in the play area which were secure by lock and contained CCC supplies. LPA observed age-appropriate toys/play equipment in the play areas. The toys/play equipment are free of sharp, loose, or pointed objects. No bodies of water were observed on site. LPA reminded Site Supervisor to have toys and play equipment, both inside and outside replaced when such items begin to degrade or are not in good repair. Play structures have adequate cushion to absorb for falls. LPA observed no bodies of water on site.

A sampling of staff and children's records were reviewed. The children’s records were complete and found to contain emergency contact information as well as immunization records. Staff records were reviewed and found to be current with Pediatric First Aid/CPR (EMSA Approved) and Mandated Reporter Training certifications, as well as documentation supporting qualifications and experience. Site Supervisor informed LPA no firearms are on site.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of “medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication. Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-carecenters/.

Facility Representative was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Facility Representative was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Shane Loftus
LICENSING EVALUATOR SIGNATURE:

DATE: 03/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/05/2025
LIC809 (FAS) - (06/04)
Page: 2 of 3
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: CAPSLO - CUESTA HEAD START - RM 4011
FACILITY NUMBER: 406213418
VISIT DATE: 03/05/2025
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

No deficiencies were cited during today’s inspection. 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 Penny Glass.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Shane Loftus
LICENSING EVALUATOR SIGNATURE:

DATE: 03/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/05/2025
LIC809 (FAS) - (06/04)
Page: 3 of 3