421712022-8-22-2024-17-CC-EBAY-D8DT9F-20240822143153

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 421712022
Report Date: 08/22/2024
Date Signed: 08/22/2024 02:32:03 PM

Document Has Been Signed on 08/22/2024 02:32 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 - CUYAMA CENTER		FACILITY NUMBER:	421712022
ADMINISTRATOR/ DIRECTOR:	KIM EICHERT		FACILITY TYPE:	850
ADDRESS:	2300 HIGHWAY 166		TELEPHONE:	(661) 522-8813
CITY:	CUYAMA	STATE: CA	ZIP CODE:	93254
CAPACITY: 24	TOTAL ENROLLED CHILDREN: 24	CENSUS: 14	DATE:	08/22/2024
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	10:30 AM
MET WITH:	Bertha Zendejas De Godoy		TIME VISIT/ INSPECTION COMPLETED:	01:00 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 8/22/24, at 10;30 AM, Licensing Program Analysts (LPAs) Elvin Baddley and Matthew Sapien conducted an unannounced Three Year Required inspection of the CAC (CommUnify)- Cuyama Child Care Center (CCC). LPAs met with Bertha Zendejas De Godoy, Site Supervisor of the CCC and explained the purpose of the inspection. LPAs toured the interior and exterior of the CCC. The CCC operates out of a single classroom (#5) on the grounds of Cuyama Elementary School. The CCC's hours of operation are from 8:00 AM to 2:30 PM, Monday - Friday. LPAs observed 14 children on site, along with three teachers (cleared and associated) providing care and supervision. LPAs note Site Supervisor is assisting with the direct care and supervision on children at the time of the inspection. LPAs observed required licensing forms and documents posted on the classroom's wall near the entry of the CCC. LPAs reviewed children's In/Out forms which contained the arrival and departure times of children in care as well as the signature of children's authorized representatives/parents. LPAs observed a carbon monoxide detector on the wall of the classroom. The detector was not tested as children in care were in the process of beginning a nap/sleep period. Site supervisor informed LPAs the carbon monoxide detector was last tested on 8/5/24. Disinfectants, cleaning solutions and sharps are located in locations in the classroom which make such items inaccessible to children in care. The CCC has First Aid kits which are accessible to staff members, yet inaccessible to children in care. The classroom of the CCC is observed to be organized and clean. The classroom has ample storage space for each child in care. The classroom has age appropriate furnishings, toys and play equipment for preschool aged children. The classroom has an operable refrigerator which contains food items consumed by the CCC's children. The CCC provided snacks, breakfast and lunch to children. Food for children is prepared by elementary school staff. LPAs observed a menu posted near the entry of the CCC. There is available drinking water for children inside and outside. 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 (CONT. 809-C, Page 2)

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE:	DATE: 08/22/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2024

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 - CUYAMA CENTER	FACILITY NUMBER: 421712022
	VISIT DATE: 08/22/2024

NARRATIVE

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except after the date of the first test. For child care center 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). LPAs verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

The restrooms of the CCC are on the elementary school grounds. Children in care are escorted to the restrooms and staff members stay in proximity of the restrooms when in use. LPAs observed the restrooms to be in sanitary operating condition. LPAs also observed waste receptacle with tight fitting lids throughout the CCC.

The outdoor play area is just outside of the CCC's classroom. LPAs observed the play area to be enclosed by chain link fencing. The fence’s entry/exit gates are secured. Toys, play equipment and furnishings in the outdoor area is age appropriate. The toys, play equipment and furnishings are in suitable condition and free of sharp, loose or pointed objects. Site Supervisor is informed to replace toys, play equipment and furnishings when such items begin to degrade and are not in good repair. The play structures in the outdoor area have adequate cushioning materials to absorb falls. Shade in the outdoor area is provided by trees in the area as well as building overhangs. No bodies of water are observed on site.

LPAs reviewed staff and children records. The children’s records are complete and found to contain emergency contact information, immunization records and parents rights, amongst other required licensing documents. Staff records are reviewed and contained current Pediatric CPR/First Aid, immunization records and educational experience, amongst other required licensing documents. The fire drill records for the CCC are reviewed. LPAs note the last fire drill on site occurred on 5/14/24. Site Supervisor informed LPAs no firearm or ammunition is stored on site.

This facility provides Incidental Medical Services – IMS. LPAs 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,
(809-C, Page 3)

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE:	DATE: 08/22/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2024

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 - CUYAMA CENTER	FACILITY NUMBER: 421712022
	VISIT DATE: 08/22/2024

NARRATIVE

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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.

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 Berta Zendejas De Godoy.

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE:	DATE: 08/22/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2024

LIC809 (FAS) - (06/04)

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