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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 421711657
Report Date: 10/18/2024
Date Signed: 10/18/2024 11:09:12 AM

Document Has Been Signed on 10/18/2024 11:09 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:COLUMBIA CHILDREN'S CENTER, INC.FACILITY NUMBER:
421711657
ADMINISTRATOR/
DIRECTOR:		CORTNEY DASMANNFACILITY TYPE:
850
ADDRESS:840 EAST STOWELL ROADTELEPHONE:
(805) 922-5437
CITY:SANTA MARIASTATE: CAZIP CODE:
93454
CAPACITY: 82TOTAL ENROLLED CHILDREN: 82CENSUS: 69DATE:
10/18/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:50 AM
MET WITH:Cortney Dasmann TIME VISIT/
INSPECTION COMPLETED:
11:15 AM
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On October 18, 2024 Licensing Program Analyst (LPA) Giovani Gonzalez conducted an unannounced Case Management - Incident inspection at the above-mentioned Child Care Center (CCC). LPA met with Director Cortney Dasmann and informed them the purpose of the inspection. At the time of the inspection 69 children were present.

On September 19, 2024 the CCC self reported an incident where Child 1 (C1) was running and fell, cutting their finger which required stitches. Director stated the family was notified, given an incident report and were provided the video of the incident to as well.

Director provided LPA the video of the incident. LPA observed there were no tripping hazards when child fell. LPA observed they tripped and fell where the turf meets the concrete.

LPA notes the CCC conducted the appropriate steps in notifying the family, reporting the incident to CCL.

No deficiencies are being given as a result of the incident.

Report reviewed was reviewed with Director Cortney. Notice of site visit was given.
SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Giovani Gonzalez
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)
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