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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 421710902
Report Date: 08/28/2024
Date Signed: 08/30/2024 08:59:17 AM

Document Has Been Signed on 08/30/2024 08:59 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRAL COAST-CHILD, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:STARR KING PARENT CHILD WORKSHOPFACILITY NUMBER:
421710902
ADMINISTRATOR/
DIRECTOR:		STOREY,CALAISFACILITY TYPE:
850
ADDRESS:1525 1/2 SANTA BARBARA STREETTELEPHONE:
(805) 966-1325
CITY:SANTA BARBARASTATE: CAZIP CODE:
93101
CAPACITY: 49TOTAL ENROLLED CHILDREN: 49CENSUS: 27DATE:
08/28/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:15 PM
MET WITH:Calais Storey TIME VISIT/
INSPECTION COMPLETED:
01:00 PM
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On August, 28, 2024 Licensing Program Analyst (LPA) Giovani Gonzalez conducted an unannounced Case Management inspection at the above-mentioned Child Car Center (CCC) to complete a confirmation of removal of Staff 1 (S1) . LPA met with Director Calais Storey and informed them the purpose of the inspection. At the time of the inspection there were 27 children present, 2 staff and 9 parent volunteers.

LPA discussed the Confirmation of removal with the director. Director stated that Staff 1 is not present at the facility and that S1 has not been present since the previous school year in compliance with the criminal record clearance requirements. Director also provided LPA a signed copy of LIC300B Confirmation of removal. LPA did not observe S1 to be present at the facility.

Verification of removal in complete.

Exit interview was conducted with Director Calais Storey. Notice of site visit was given.

SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Giovani Gonzalez
LICENSING EVALUATOR SIGNATURE: DATE: 08/28/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/28/2024
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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