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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 421709731
Report Date: 10/18/2024
Date Signed: 10/18/2024 03:23:26 PM

Document Has Been Signed on 10/18/2024 03:23 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:CAC - GUADALUPE CENTERFACILITY NUMBER:
421709731
ADMINISTRATOR/
DIRECTOR:		ELVA QUINTANILLAFACILITY TYPE:
850
ADDRESS:130 TOGNAZZINI AVETELEPHONE:
(805) 343-5598
CITY:GUADALUPESTATE: CAZIP CODE:
93434
CAPACITY: 25TOTAL ENROLLED CHILDREN: 25CENSUS: 14DATE:
10/18/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:45 AM
MET WITH:Elva QuitanillaTIME VISIT/
INSPECTION COMPLETED:
01:30 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 10/18/24, at 11:45 AM, Licensing Program Analyst (LPA) Elvin Baddley conducted an unannounced Annual/Random inspection of the abovementioned Child Care Center (CCC). LPA met with Elva Quitanilla, Site Supervisor of the CCC. LPA explained the purpose and nature of the inspection to Site Supervisor. LPA, in the company of Site Supervisor toured the interior and exterior of the CCC. The facility also share grounds with the CAC- Maggie Espinoza Center, which has a separate Preschool license. The CCC uses one classroom for child care services. The CCC operates from 6:30 AM to 5:00 PM, Monday- Friday. At the time of inspection, LPA observed 14 children on site, along with two teachers (cleared and associated).

LPA observed required licensing forms and documents posted on the wall near the entry door of the classroom. LPA observed a schedule of activities sheet along with a posted menus affixed to the wall of the classroom. LPA observed the CCC's Sign In/Out forms near the CCC's entry door of each classroom. The Sign In/Out forms contained the arrival and departure times of children in care and well as the signatures of the children's authorized representatives. The classroom is subdivided in to different learning and activity areas. Each area in the classroom has age appropriate equipment and furnishings available to children in care. The CCC has a carbon monoxide detector on site which was tested at 12:09 PM and found to be operable. The CCC uses a single restroom for children, The restroom has observed to be in safe and sanitary operating condition. The CCC has a kitchen on site which is inaccessible to children in care. LPA observed an operable refrigerator in the CCC's kitchen which stores food and beverages for children in care. The CCC provides breakfasts and lunches to children as well as snacks. The CCC also has available (filtered) drinking water for children inside and outside of the facility. Children can also access water from the building's fountains. CCCs constructed before 1/1/20, to test their water (used for drinking and food preparation) for lead contamination before 1/1/23, and then every 5 years after the date of the first test. For CCC 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 was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

Disinfectants, cleaning solutions and sharps are observed in secure and (CONT. LIC 809, Page 2)

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE: DATE: 10/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/18/2024
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 3
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: CAC - GUADALUPE CENTER
FACILITY NUMBER: 421709731
VISIT DATE: 10/18/2024
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
elevated cabinets in the CCC. Site Supervisor informed LPA no medication is stored on site at this time, however when medication is on site, the medication is located in a locked cabinet drawer nearing the CCC's posted documents and forms. The aforementioned is inaccessible to children in care. The CCC has a First Aid kit on site.

The CCC outdoor playground area is enclosed by chained link fencing. The fence’s entry/exit gates are secured. The surfaces of the outdoor playground area is varied. LPA observed two sheds in the outdoor area. The sheds are secured and contains excess CCC supplies. LPA observed age appropriate play equipment in the outdoor play area. The play equipment in the outdoor play area are free of sharp, loose or pointed objects. The play structures in the outdoor playground area has adequate cushioning materials to absorb falls and shade created by building overhangs, shade sails and trees. LPA reminded Site Supervisor to replace outdoor play equipment and furnishings when such items begin to degrade or are not in good repair. LPA observed no bodies of water at the CCC.

LPA reviewed children, staff and facility records. The children’s records sampled were complete and found to contain emergency contact information and immunization records, among other required licensing documentation and forms. Staff records were reviewed. Staff records sampled were complete and found to contain First Aid/CPR certifications (EMSA approved) and Mandated Reporter Training certification, among other required licensing documentation and forms. LPA notes the last disaster drill at the facility occurred on 9/30/24. Site Supervisor informed LPA no firearms or ammunition are stored on the premises.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of “medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. 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 (TTY) 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,
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 (CONT. LIC 809-C, Page 3)
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE:

DATE: 10/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/18/2024
LIC809 (FAS) - (06/04)
Page: 2 of 3
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: CAC - GUADALUPE CENTER
FACILITY NUMBER: 421709731
VISIT DATE: 10/18/2024
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
violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

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.

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 Elva Quitanilla.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE:

DATE: 10/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/18/2024
LIC809 (FAS) - (06/04)
Page: 3 of 3