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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 421712288
Report Date: 09/22/2022
Date Signed: 09/22/2022 03:29:40 PM

Document Has Been Signed on 09/22/2022 03:29 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:FIRST PRESBYTERIAN EARLY CHILDHOOD CENTERFACILITY NUMBER:
421712288
ADMINISTRATOR:BETH HASSENPLUGFACILITY TYPE:
850
ADDRESS:21 E. CONSTANCE AVENUETELEPHONE:
(805) 687-6362
CITY:SANTA BARBARASTATE: CAZIP CODE:
93105
CAPACITY: 59TOTAL ENROLLED CHILDREN: 59CENSUS: 36DATE:
09/22/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Dany RodriguezTIME COMPLETED:
03:35 PM
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On September 22nd2022, at 2:30PM, Licensing Program Analyst (LPA) Rosie Breault made an unannounced inspection for the purpose of conducting a Case Management - Incident inspection. LPA met with assistant director, Dany Rodriguez and discussed the purpose of the inspection. LPA and licensee conducted a tour of the facility (facility is strictly outdoors at this time) and there were 36 children and 6 staff at the time of the inspection.

On 9/21/2022, director contacted Community Care Licensing (CCL) to self-report an incident that occurred on 9/20/22 of 1 child climbing a structure, falling, and breaking arm. Incident witness by assistant director Dany Rodriguez. At roughly 4:20pm, assistant director states child was on a walking bridge in front of her. (LPA notes bridge is wide and 1 foot off the ground), then child proceed to sit down on bridge facing assistant director. Child then fell forward and landed on belly. Assistant director helped child up and said she would get child “cleaned up” but child said, “why there is no blood?” Assistant director meant the wood chips on child's clothes. Child did not cry however a few minutes later child was complaining left wrist area was hurting. Staff offered ice pack, but child declined, staff commenced to comfort child. Assistant director saw child trying to comfort with a pillow/blanket (wrapping it around wrist).

CONTINUED ON LIC809C

SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Maryrose Breault
LICENSING EVALUATOR SIGNATURE: DATE: 09/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/22/2022
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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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: FIRST PRESBYTERIAN EARLY CHILDHOOD CENTER
FACILITY NUMBER: 421712288
VISIT DATE: 09/22/2022
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At that point (4:43pm), assistant director contact mom via text and father came to pick up at 5:15pm. At 8:18pm that evening, assistant director received a text from mom stating they took child to get a X-ray and child had broken arm by elbow area. Child returned to school today (9/22/2022) for half day. LPA noted child has a hard cast from wrist to elbow on left arm and is playing outside with children. LPA spoke with child's teacher Elise who stated parents did not inform her of any restrictions other than cast is not waterproof and did not provide the facility any medication to administer to child.

No deficiencies were cited during today's visit.

THE NOTICE OF SITE VISIT AND MUST REMAIN POSTED FOR 30 DAYS OR A CIVIL PENALTY OF $100.00 WILL APPLY.

SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Maryrose Breault
LICENSING EVALUATOR SIGNATURE:

DATE: 09/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2022
LIC809 (FAS) - (06/04)
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