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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 406215080
Report Date: 08/31/2026
Date Signed: 08/31/2026 03:50:46 PM

Document Has Been Signed on 08/31/2026 03:50 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:WISHING WELL SCHOOL OF THE CENTRAL COASTFACILITY NUMBER:
406215080
ADMINISTRATOR/
DIRECTOR:		KIMBERLY RAINEFACILITY TYPE:
840
ADDRESS:880 MANZANITATELEPHONE:
(805) 235-4401
CITY:LOS OSOSSTATE: CAZIP CODE:
93402
CAPACITY: 42TOTAL ENROLLED CHILDREN: 42CENSUS: 0DATE:
08/31/2026
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:36 AM
MET WITH:Kim WishonTIME VISIT/
INSPECTION COMPLETED:
01:45 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 August 31, 2026 at 9:36 AM, Licensing Program Analyst (LPA) Bill Billones arrived at the facility unannounced to conduct an Annual Random inspection of the above referenced Child Care Center (CCC). LPA met with Interim Director Kim Wishon and explained the nature of the inspection. The CCC is an after school program that operates on an elementary school site from 3:00 PM to 5:00 PM, Monday through Friday. LPA notes no children were present during the inspection as the school year has not yet started.

LPA toured the physical plant inside and outside. LPA notes the facility’s license and other required licensing documentation were not posted. The CCC utilizes classrooms #15 and #16. LPA observed classroom #15 currently undergoing rearrangement and preparation for the start of the school year. LPA advised Interim Director to ensure classroom is ready prior to caring for children. LPA observed classroom #16 meets the needs of children in care. The classrooms have adequate spacing and ventilation. LPA observed age-appropriate equipment and furnishings throughout the CCC. A carbon monoxide detector was observed and tested in each classroom, which were both found to be functional. The CCC’s restrooms were in sanitary condition and free of any hazardous items for children in care. There is an additional sink within the classroom for children’s use. A dispenser of filtered water used for drinking was observed inside each classroom. LPA reminded the Interim Director to ensure that all hazardous items are stored in secure locations and remain inaccessible to children in care at all times. Director states prescription medications are not administered. Per Interim Director, no firearms or ammunition are stored on site.

CONTINUED ON LIC809-C

Ana Tolentino
Bill-Brian Billones
DATE: 08/31/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/31/2026
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 6
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)
Page: 2 of 6
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: WISHING WELL SCHOOL OF THE CENTRAL COAST
FACILITY NUMBER: 406215080
VISIT DATE: 08/31/2026
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
LPA observed the outdoor play spaces are fully enclosed by fencing and notes there are age-appropriate outdoor play equipment for children’s use. LPA observed one gate could not close properly and a broken piece of wood was observed on one wooden structure. Interim Director states children use the space on an alternating schedule with the other school programs. No bodies of water were observed.

A sample of children’s records were reviewed, which were found to be incomplete with required licensing documentation. One child’s file was missing the following forms: Notification of Parents’ Rights (LIC995), Personal Rights (LIC613A), and the Consent for Emergency Medical Treatment (LIC627). LPA notes the mandated reporter training for the Interim Director was not taken from a valid vendor. At least one staff record had a valid first aid/CPR certificate. One staff file was missing records to verify immunizations required. Two staff files did not have the Personnel Record (LIC501) nor the Health Screening Record (LIC503), including valid TB clearances. Educational experience could not be verified for one staff record. LPA reminded Interim Director it is their responsibility to ensure children and staff files are maintained. Additionally, Interim Director stated their intention to submit a full directorship packet. Last fire drill was conducted on 02/27/2026. The center utilizes a paper sign-in and out sheet.

Interim Director 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.

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 as specified in Health and Safety Code section 1597.16. 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 (Interim Licensing Standards) outlined in PIN 21-21.1-CCP. LPA referred Director to the Department website for lead: Lead Toxicity Prevention and Water Testing Information (https://www.cdss.ca.gov/inforesources/child-care-licensing/water-testing-information).

CONTINUED ON LIC809-C

NAME OF LICENSING PROGRAM MANAGER: Ana Tolentino
NAME OF LICENSING PROGRAM ANALYST: Bill-Brian Billones
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/31/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2026
LIC809 (FAS) - (06/04)
Page: 3 of 6
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: WISHING WELL SCHOOL OF THE CENTRAL COAST
FACILITY NUMBER: 406215080
VISIT DATE: 08/31/2026
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
CCC COMPLETED TESTING AND NO LEAD EXCEEDANCES. LPA notes the last lead testing report was generated on 05/16/2023. This report had listed lead exceedances in Rooms #13 and #14, which are not classrooms licensed for this facility.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/.

Interim Director 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.

In areas evaluated, four (4) Type B deficiencies are being cited under Title 22 and Health and Safety Code, which can be found the attached LIC 809-D.

A notice of site visit was given and must remain posted for 30 days. Appeal rights were provided.

Exit interview conducted and report was reviewed with Interim Director Kim Wishon.

NAME OF LICENSING PROGRAM MANAGER: Ana Tolentino
NAME OF LICENSING PROGRAM ANALYST: Bill-Brian Billones
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/31/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2026
LIC809 (FAS) - (06/04)
Page: 4 of 6
Document Has Been Signed on 08/31/2026 03:50 PM - It Cannot Be Edited


Created By: Bill-Brian Billones On 08/31/2026 at 01:43 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: WISHING WELL SCHOOL OF THE CENTRAL COAST
FACILITY NUMBER: 406215080

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/31/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.7995(a)(1)
General Provisions and Definitions
(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on record review, the licensee did not comply with the section cited above in one staff (staff #3) file missing an immunization record, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/10/2026
Plan of Correction
1
2
3
4
Licensee will email staff #3's immunization to LPA Billones' Department email at bill.billones@dss.ca.gov no later than 09/10/2026.
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 record review, the licensee did not comply with the section cited above whereas Interim Director does not posess a valid mandated reporter training certifcate from an approved vendor, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/10/2026
Plan of Correction
1
2
3
4
Licensee will email the above staff's valid certificate to LPA Billones' Department email at bill.billones@dss.ca.gov no later than 09/10/2026.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Ana Tolentino
NAME OF LICENSING PROGRAM MANAGER:
Bill-Brian Billones
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 08/31/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/31/2026


LIC809 (FAS) - (06/04)
Page: 5 of 6
Document Has Been Signed on 08/31/2026 03:50 PM - It Cannot Be Edited


Created By: Bill-Brian Billones On 08/31/2026 at 01:43 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: WISHING WELL SCHOOL OF THE CENTRAL COAST
FACILITY NUMBER: 406215080

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/31/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101216(g)(1)
Personnel Requirements
(1) Except as specified in (3) below, good physical health shall be verified by a health screening, including a test for tuberculosis, performed by or under the supervision of a physician not more than one year prior to or seven days after employment or licensure.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on record review, the licensee did not comply with the section cited above in two staff files (staff #2 and staff #3) missing a physician verified health screening report, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/10/2026
Plan of Correction
1
2
3
4
Licensee will email staff #2 and staff #3's health screening report (LIC503) to LPA Billones' Department email at bill.billones@dss.ca.gov no later than 09/10/2026.
Type B
Section Cited
CCR
101217(a)(6)
Personnel Records
(a) The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. Each personnel record shall contain the following information: (6) Documentation of the educational background, training and/or experience specified in this chapter.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on record review, the licensee did not comply with the section cited above in two staff files (staff #2 and staff #3) missing the personnel record (LIC501), which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/10/2026
Plan of Correction
1
2
3
4
Licensee will email staff #2 and staff #3's personnel report (LIC501) to LPA Billones' Department email at bill.billones@dss.ca.gov no later than 09/10/2026.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Ana Tolentino
NAME OF LICENSING PROGRAM MANAGER:
Bill-Brian Billones
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 08/31/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/31/2026


LIC809 (FAS) - (06/04)
Page: 6 of 6