406215068-2-19-2025-17-CC-MSAN-DE2UCU-20250219142831

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 406215068
Report Date: 02/19/2025
Date Signed: 02/19/2025 02:28:51 PM

Document Has Been Signed on 02/19/2025 02:28 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:	LITTLE ARK PRESCHOOL		FACILITY NUMBER:	406215068
ADMINISTRATOR/ DIRECTOR:	TRACY BROWN		FACILITY TYPE:	850
ADDRESS:	5545 ARDILLA AVENUE		TELEPHONE:	(805) 466-9544
CITY:	ATASCADERO	STATE: CA	ZIP CODE:	93422
CAPACITY: 40	TOTAL ENROLLED CHILDREN: 40	CENSUS: 0	DATE:	02/19/2025
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	12:25 PM
MET WITH:	Tracy Brown		TIME VISIT/ INSPECTION COMPLETED:	02:50 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 2/19/25, at 12:25 PM, Licensing Program Analyst (LPA) Matthew Sapien conducted an unannounced random inspection of the abovementioned Child Care Center (CCC). LPA met with Tracy Brown, Director of the CCC, and explained the nature and purpose of the inspection. The LPA, in the company of the Director, toured the interior and exterior of the CCC. The CCC utilizes two classrooms (3 Year Old Classroom and 4 Year Old Classroom), 2 restrooms, and an outdoor play area. The CCC is located on the grounds of Legacy Church. The CCC's hours of operation are 8:00 AM until 12:00 PM Tuesday through Thursday. During the inspection, LPA observed a total of zero children in care along with 3 additional staff members (cleared and associated). Each of the classrooms of the CCC are clean and orderly. The classrooms have age-appropriate toys, books, and other furnishings for children in care. Each classroom contains cabinets and other storage containers for related childcare equipment and items. The CCC's bathrooms possess an adequate number of toilets and sinks. The bathrooms were found to be clean, orderly, and rid of any hazardous items for children in care. The CCC possesses a full-sized kitchen with an operational refrigerator which contains food items for children in care. The kitchen area is off limits to the CCC's children. The CCC provides one morning snack children in care. There is available drinking water for children at the CCC via filtered water jugs and a water fountain in the 4 Year Old Classroom. Children are supplied with paper cups to drink with. CCCs constructed before 1/1/20, are supposed to test their water (used for drinking and food preparation) for lead contamination before 1/1/23, and then every 5-years except after the date of the first test. For child care center licenses issued after 7/1/22, 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 (CONT. LIC 809-C, Page 2).

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Matthew Sapien
LICENSING EVALUATOR SIGNATURE:	DATE: 02/19/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/19/2025

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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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: LITTLE ARK PRESCHOOL	FACILITY NUMBER: 406215068
	VISIT DATE: 02/19/2025

NARRATIVE

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was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

LPA observed snack menus and required notices and other relevant documents posted prominently within the CCC. LPA also reviewed the children's sign in/sign out forms and found the arrival times of children, along with the departure times. The signatures of authorized representatives were also present.

LPA observed a carbon monoxide detector in the CCC's 3 Year Old Classroom. The detector was tested at 1:32 PM and was found to be operational. Cleaning compounds are store in elevated areas in each of the classrooms and sharps are stored in locked compartments in the classrooms as well. No children currently require medication. LPA also observed a First Aid kit in the CCC that contains appropriate First-Aid supplies.

The outdoor playground area is enclosed by chain linked fencing throughout. The fence’s entry/exit gates are secure and furnishings in the area are age appropriate. The play structure in the outdoor play area has adequate cushioning material (rock pebbles) to absorb falls. The footing of the exterior is varied (concrete pavement, grass, sand, and rock pebbles). Shade is provided by building overhangs nearby. LPA observed 2 storage sheds in the play area, each of which possess equipment for children in care and yard work equipment as well. These storage compartments are locked during outdoor play time. Director attested that children are always supervised while outside and that the outdoor area is inspected prior to letting children outside.

A sampling of staff and children's records were reviewed. The children’s records were complete and were found to contain emergency contact information as well admission agreements, among other relevant licensing documents and forms. Staff records were reviewed. Facility records show the last fire drill on site occurred on 1/21/25. Director informed LPA that disaster drills are conducted every month as opposed to every six months as required by the Department. LPA confirmed that there are no bodies of water, firearms, or ammunition that are stored on site.

This facility does not currently provide Incidental Medical Services – IMS. 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 and link to publication Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

Facility representative was reminded that all adults 18 and over, including employees and volunteers,

(CONT. 809-C, Page 3)

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Matthew Sapien
LICENSING EVALUATOR SIGNATURE:	DATE: 02/19/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/19/2025

LIC809 (FAS) - (06/04)

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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: LITTLE ARK PRESCHOOL	FACILITY NUMBER: 406215068
	VISIT DATE: 02/19/2025

NARRATIVE

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as specified in HSC 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.

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.

During today's visit, two Type B deficiencies were issued (see LIC 809-D pages). Director was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these rights.

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, Tracy Brown.

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Matthew Sapien
LICENSING EVALUATOR SIGNATURE:	DATE: 02/19/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/19/2025

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 02/19/2025 02:28 PM - It Cannot Be Edited

Created By: Matthew Sapien On 02/19/2025 at 02:17 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: LITTLE ARK PRESCHOOL	FACILITY NUMBER: 406215068
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/19/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on interview and record review, the licensee did not comply with the section cited above which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 03/05/2025
	Plan of Correction
1 2 3 4	The CCC will submit a Mandated Reporter Training Certificate to CDSS CCLD (matthew.sapien@dss.ca.gov) by close of business day (5:00 PM) on 3/5/25.

Type B

Section Cited

CCR

101216(f)

Personnel Requirements

(f) At least one staff member who is trained in pediatric cardiopulmonary resuscitation and pediatric first aid pursuant to Health and Safety Code Section 1596.866 shall be present when children are at the child care center or offsite for center activities. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on interview and record review, the licensee did not comply with the section cited above which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 03/05/2025
	Plan of Correction
1 2 3 4	The CCC will submit a CPR Certificate to CDSS CCLD (matthew.sapien@dss.ca.gov) by close of business day (5:00 PM) on 3/5/25.

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:

Matthew Sapien

LICENSING EVALUATOR SIGNATURE:

DATE: 02/19/2025

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/19/2025

LIC809 (FAS) - (06/04)

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