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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 406213418
Report Date: 03/05/2025
Date Signed: 03/05/2025 12:45:35 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:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:01 PM
MET WITH:Penny GlassTIME VISIT/
INSPECTION COMPLETED:
01:00 PM
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On 3/5/25, Licensing Program Analyst (LPA) Shane Loftus conducted an unannounced Case Management Inspection of the above-mentioned Child Care Center (CCC) to address an incident report received by CCLD on 1/30/25. LPA notes 9 children are in care at the time of the inspection along with 3 teachers providing care and supervision.

Site Supervisor provided LPA an account of what transpired. The incident in question is regarding C1 being left in the play yard when class transitioned to the big yard. The incident occurred on 1/27/25. Specifically, the class was transitioning from the play yard in front of the classroom to the big (communal) yard. Once in the big yard, S1 noticed that C1 was missing. S1 returned to the play yard and returned the child to the big yard. It is estimated that the child was in the play yard for no more than 5 minutes.

The CCC has since implemented multiple processes to account for the children present. A meeting with area manager has also taken place to discuss policies regarding supervision to ensure this does not reoccur.

No deficiencies were cited during today's inspection. A Notice of Site Visit (LIC 9213) was given and must remain posted for 30 days. Failure to comply with posting requirements may result in a civil penalty of $100. Exit interview conducted and report was reviewed with 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
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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