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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 406216618
Report Date: 08/27/2026
Date Signed: 08/27/2026 04:24:00 PM

Document Has Been Signed on 08/27/2026 04:24 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:PEACE CHRISTIAN PRESCHOOL & INFANT CENTERFACILITY NUMBER:
406216618
ADMINISTRATOR/
DIRECTOR:		DORIS ANGELFACILITY TYPE:
830
ADDRESS:244 N. OAK PARK BLVDTELEPHONE:
(805) 489-9644
CITY:ARROYO GRANDESTATE: CAZIP CODE:
93420
CAPACITY: 12TOTAL ENROLLED CHILDREN: 12CENSUS: DATE:
08/27/2026
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:45 PM
MET WITH:Carly RichardsonTIME VISIT/
INSPECTION COMPLETED:
04:40 PM
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On August 27, 2026 Licensing Program Analyst (LPA) Elizabeth George conducted an unannounced annual random inspection at the above-mentioned Child Care Center (CCC). LPA met with Facility Representative, Carly Richardson, and discussed the purpose of the inspection. At the time of the inspection 8 children and 2 staff were present. LPA notes staff present maintain a criminal record clearance but are not associated to the facility. The infant centers hours of operation are from 8:30am – 4:30pm, Monday thru Friday. The center is located on the grounds of Peace Lutheran Church.

LPA in the company of the Facility Representative toured the interior and exterior of the facility. The CCC consists of one infant classroom and one infant outdoor play area. Required licensing forms were posted on the wall in the classroom entryway. LPA observed a baby bouncer and a Bumbo without the safety latch in the classroom. Items were removed during the inspection. The activity space in the classroom is not separate from the sleeping area. LPA observed the classroom to be clean and orderly. Age-appropriate toys and equipment are in good condition. Facility Representative informed LPA cleaning compounds are stored in an elevated cabinet. LPA observed cabinets and drawers that are not secured to be free of hazards. LPA observed dual smoke and carbon monoxide detector and fire alarm which site supervisor stated are checked regularly to ensure they are functioning. LPA observed a regulation fire extinguisher serviced within the last year in the classroom. LPA notes the changing area is separated from the activity space and is located near a sink.

continued on LIC809-C
Ana Tolentino
Elizabeth George
DATE: 08/27/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/27/2026
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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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)
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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: PEACE CHRISTIAN PRESCHOOL & INFANT CENTER
FACILITY NUMBER: 406216618
VISIT DATE: 08/27/2026
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LPA observed the outdoor play area to be surrounded by a chain link fencing with sufficient space for children’s activities. The flooring consists of a grassy area as well as concrete. LPA observed age-appropriate toys and equipment in good repair. Drinking water is made available via filtered water jug both inside the classroom and outside.

A sampling of children's files was reviewed. During the review of six children’s files, several required documents were found to be incomplete or missing. Specifically:
· Five out of six children’s files were missing the Infant Needs and Services Plan.
· All three children under 12 months were missing the LIC 9227 – Individual Infant Sleeping Plan.
· Two out of six children’s files were missing the Physician’s Report.
· Three out of six children’s files were missing documentation of immunizations.
The Director must ensure that all children’s files are complete, accurate, and maintained in accordance with Title 22 regulations. Facility Representative was reminded that the time of each 15 minute sleep check must be documented.

LPA reviewed files for the staff present which were found to be incomplete. All staff files must include the LIC503 Health Screening, immunization’s and TB clearance for each staff member. LPA reminded Facility representative it is their responsibility to ensure both children’s and staff files are complete and current. LPA notes at least one staff has current Pediatric CPR and First Aid Certification. LPA observed fire drills are being conducted and logged with the last fire drill on 4/15/26. LPA observed through the Playground Application that sign in and out logs are filled out appropriately for the children that are present. LPA did not observe any bodies of water on site. There are no fire arms or ammunition on CCC site.

Parents are responsible for providing all food, formula, bottles, and nipples needed for their child while in care. All items are brought to the facility ready for the children to consume. All food items are sent home daily. The classroom contains a mini refrigerator which contains formulas and breast milk for children in care. Facility Representative was reminded that all items in the fridge must labeled with children’s names and dated.

continued on LIC809-C

NAME OF LICENSING PROGRAM MANAGER: Ana Tolentino
NAME OF LICENSING PROGRAM ANALYST: Elizabeth George
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/27/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2026
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: PEACE CHRISTIAN PRESCHOOL & INFANT CENTER
FACILITY NUMBER: 406216618
VISIT DATE: 08/27/2026
NARRATIVE
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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.


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, on 8/15/23, in accordance to the Written Directives (Interim Licensing Standards) outlined in PIN 21-21.1-CCP. No Lead exceedances were found.

LPA referred Facility representative 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).

LPA discussed the safe sleep regulations with Facility representative 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 additional resource. LPA also informed facility representative of the importance of checking for and removing any 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.

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/.


continued on LIC809-C
NAME OF LICENSING PROGRAM MANAGER: Ana Tolentino
NAME OF LICENSING PROGRAM ANALYST: Elizabeth George
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/27/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2026
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: PEACE CHRISTIAN PRESCHOOL & INFANT CENTER
FACILITY NUMBER: 406216618
VISIT DATE: 08/27/2026
NARRATIVE
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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.

During today's inspection three Type B citations were issued under CCR, Title 22 and can be found on the attached LIC809-D’s. Seven technical violations were issued.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted, appeals rights were provided and report was reviewed with the Facility Representative, Carly Richardson.

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.

NAME OF LICENSING PROGRAM MANAGER: Ana Tolentino
NAME OF LICENSING PROGRAM ANALYST: Elizabeth George
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/27/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2026
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 08/27/2026 04:24 PM - It Cannot Be Edited


Created By: Elizabeth George On 08/27/2026 at 03:45 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: PEACE CHRISTIAN PRESCHOOL & INFANT CENTER
FACILITY NUMBER: 406216618

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/27/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101438.3(c)(1)
Indoor Activity Space For Infants
(1) The sleeping area for infants shall be physically separate from the indoor activity space. This separation shall be accomplished as specified in (b) above.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above in the activity area for the children is the same area where the cribs are stored and the children nap in both cribs and mats on the floor which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/11/2026
Plan of Correction
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Licensee to correct the napping and activity area to follow regulations. Facility representative was reminded the activity area shall accommodate 35 square feet of space for licensed capacity. LPA will return to facility to ensure regulation's are met.
Type B
Section Cited
CCR
101419.2(b)(2)
Infant Needs and Services Plan
(b) The needs and services plan shall be in writing and shall include the following: (2) Infants up to 12 months of age shall have a completed Individual Infant Sleeping Plan [LIC 9227 (3/20)], which is incorporated by reference.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in children's files for infants under 12 months did not contains the LIC 9227 in 3 out of 3 files reviewed which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/04/2026
Plan of Correction
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Children's files to be updated with the LIC9227. Proof can be emailed to LPA at elizabeth.george@dss.ca.gov no later than September 4, 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:
Elizabeth George
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 08/27/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/27/2026


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 08/27/2026 04:24 PM - It Cannot Be Edited


Created By: Elizabeth George On 08/27/2026 at 03:45 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: PEACE CHRISTIAN PRESCHOOL & INFANT CENTER
FACILITY NUMBER: 406216618

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/27/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101419.3(a)
Modifications to Infant Needs and Services Plan
(a) The written infant needs and services plan shall be updated at least quarterly, or as often as necessary to assure its accuracy.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in 5 out of 6 children's files did not contain an infant needs and services plan which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/04/2026
Plan of Correction
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Each child's file shall be updated with a current Infant Needs and Services plan. Proof can be emailed to LPA at elizabeth.george@dss.ca.gov no later than September 4, 2026.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:
Elizabeth George
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 08/27/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/27/2026


LIC809 (FAS) - (06/04)
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