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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 421700377
Report Date: 11/06/2024
Date Signed: 11/06/2024 01:31:04 PM

Document Has Been Signed on 11/06/2024 01:31 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:ST. MARK PRESCHOOLFACILITY NUMBER:
421700377
ADMINISTRATOR/
DIRECTOR:
ANA SCHMIDFACILITY TYPE:
850
ADDRESS:3942 LA COLINA ROADTELEPHONE:
(805) 687-4111
CITY:SANTA BARBARASTATE: CAZIP CODE:
93110
CAPACITY: 70TOTAL ENROLLED CHILDREN: 70CENSUS: 53DATE:
11/06/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:45 AM
MET WITH:Ana SchmidTIME VISIT/
INSPECTION COMPLETED:
12:50 PM
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On November 6, 2024 at 12 PM, Licensing Program Analyst (LPA) Susana Martinez made an unannounced Case Management- Incident inspection. LPA met with director, Ana Schmid to discuss an incident that was self reported to Community Care Licensing Division (CCLD) office by phone on 11/01/2024. LPA toured the area/classroom where the incident occurred and interviewed Director.

On 10/30/24, center staff noticed C1 complaining about it's arm after nap time. C1 was assessed by center staff and informed C1's parents of the incident. Parents of C1 took child to urgent care where x-rays resulted in inconclusive findings. Parents of C1 were referred to an orthopedic clinic where C1 was diagnosed with a fractured elbow.

The Director conducted an internal investigation including interviews with staff and C1. C1 disclosed that they fell off the napping cot. Staff did not observe C1 to have fallen and/or injured their arm at the facility. Prior to nap time C1 was observed to act normal and did not complain about arm. LPA observed the napping cot to be of normal height. Furthermore it is unknown by parents and staff if child may have injured self at home.

Given the incident was appropriately handled, no deficiencies are being issued as a result of this incident.

Notice of site visit was issued and should remain posted for 30 days.

Exit interview was conducted and report was reviewed with Director Ana Schmid.
SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Susana Martinez
LICENSING EVALUATOR SIGNATURE: DATE: 11/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/06/2024
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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