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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 406215821
Report Date: 07/07/2022
Date Signed: 07/07/2022 02:38:08 PM

Document Has Been Signed on 07/07/2022 02:38 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
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:HAND IN HAND PRESCHOOL AND INFANT CENTERFACILITY NUMBER:
406215821
ADMINISTRATOR:ELLA MARIE BASTSONFACILITY TYPE:
830
ADDRESS:3172 JOHNSON AVETELEPHONE:
(805) 543-8653
CITY:SAN LUIS OBISPOSTATE: CAZIP CODE:
93401
CAPACITY: 12TOTAL ENROLLED CHILDREN: 12CENSUS: 6DATE:
07/07/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Ella BatsonTIME COMPLETED:
01:00 PM
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On 7/7/22, at 11:30 AM, Licensing Program Analyst (LPA) Elvin Baddley conducted a unannounced One Year Required inspection of the abovementioned Child Care Center (CCC). LPA met with Ella Batson, Director of the CCC and explained the purpose of the inspection. LPA, in the company of the Director, toured the interior and exterior of the CCC. The CCC operates from 7:30 AM to 5:25 PM, Monday- Friday on the grounds of Active Church in San Luis Obispo, CA.. The CCC is an infant center with a toddler component. The center use two room for care and an outdoor play area. LPA observed 6 children in care along with two teacher (associated and cleared) providing care and supervision.

The rooms (Activity Room and Crib Room) used child care services are clean, orderly and free of hazardous items. LPA observed six cribs available for use as well as age appropriate toys and furnishings. Toddlers have access to cots at the CCC. LPA observed licensing required documents and forms posted on the wall of the CCC's main play room. The CCC has operable carbon monoxide detectors, one of which was tested at 11:50 AM. Liquids and food, which includes bottles and formula, are stored in a refrigerator in the CCC's kitchen and room mini refrigerator. Bottles and food are labeled with child's name. The CCC has bottle drinking water available for children inside of the CCC and out. The CCC also provide mid day snacks to children in care.

The outdoor activity area contains age appropriate toys and equipment. The area has ample shade in the form of the building overhangs and shade covering. The entry /exit gates are secured. The area is enclosed by chain linked fencing and has foam cushioning at the base of the play structures. Director has been informed to remove equipment and toys from the area when they begin to degrade or are not in good repair. LPA observed no bodies of water on site.

LPA reviewed the files of children on site. Files contain Individual needs, service and feeding plans. LPA also reviewed sleep logs which are current. LPA reviewed staff records. Teachers have required qualifications. Teachers present have current Pediatric First Aid/CPR certificates as well as Adult Immunization and Tuberculosis Requirements. Director is reminded to renew training certifications prior to

(CONT.809-C)

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE: DATE: 07/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/07/2022
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
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: HAND IN HAND PRESCHOOL AND INFANT CENTER
FACILITY NUMBER: 406215821
VISIT DATE: 07/07/2022
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expirations. LPA notes a review of the CCC disaster drill show the last drill occurred on 6/29/22. The Director informed the LPA no firearms or ammunition is stored on site. LPA reviewed CCC sign-in/sign-out forms upon arrival at the CCC and notes the forms are completed correctly.


Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes 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: http://www.ada.gov/childqanda.htm

LPA discussed the safe sleep regulations with Director and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an
for additional resource. LPA also informed Director of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Facility representative was reminded that all adults 18 and over, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.


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 Ella Batson.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE:

DATE: 07/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2022
LIC809 (FAS) - (06/04)
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