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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 421712405
Report Date: 02/21/2024
Date Signed: 02/21/2024 04:25:06 PM

Document Has Been Signed on 02/21/2024 04:25 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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:GIRLS INCORPORATED OF CARPINTERIAFACILITY NUMBER:
421712405
ADMINISTRATOR:COLLINS, JAMIEFACILITY TYPE:
840
ADDRESS:5315 FOOTHILL ROADTELEPHONE:
(805) 684-6364
CITY:CARPINTERIASTATE: CAZIP CODE:
93013
CAPACITY: 100TOTAL ENROLLED CHILDREN: 100CENSUS: 0DATE:
02/21/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
12:40 PM
MET WITH:Gloria Flores and Tessa OrtegaTIME COMPLETED:
04:40 PM
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On February 21, 2024 at 12:50 PM, Licensing Program Analyst (LPA) Susana Martinez conducted an unannounced Required-3 Year inspection. LPA met with Tessa Ortega and advised her the purpose of the inspection. Tessa states site supervisor, Gloria was out picking up children. Tessa provided LPA a tour of the facility inside and out. At the time of inspection there were 0 children present. Center operates operates M, T, Th, and Fri 2:30PM- 5:30PM and Wed 1:00PM- 5:30PM. During the inspection Gloria Flores arrived to the facility.

LPA observed required licensing documents mounted on the wall at the entrance of the facility. Last fire drill was conducted on 2/05/2024. The facility uses 4 main rooms for day-care, LPA observed each room to be clean and orderly. LPA observed enough restrooms available for children to use. LPA did not observe any hazards/toxins accessible to children. First Aid kits were observed throughout the facility. A carbon monoxide detector was tested by Tessa at 12:57 PM, the detector was found to be in working condition. Currently the facility uses paper forms for check-in/check-out. LPA observed prior days check-in/check-out log. LPA also verified children's roster and reminded staff to keep it up to date. The facility uses an app called Remind as a form of communication. Facility provides snacks. LPA asked for snack menu, Gloria states the person in charge did not create one this week.

The outdoor playground is shaded and has an ample amount of space for children to play. LPA observed the playground has age-appropriate toys and structures available for children to use. LPA noted the artificial turf and newly renovated building directly across from the kitchen which are used as the STEM class and library. Gloria states the facility underwent changes to the grass and building about a year ago. LPA asked if the information was reported to the Department, Gloria stated she was unaware. LPA advised Gloria that any proposed alterations to existing buildings or new facilities need to be reported to the Department prior to construction. LPA provided PIN 23-20-CCP- REQUIRED NOTIFICATION PRIOR FOR MAKING CHANGES TO CHILD CARE FACILITIES.
Continued on 809-C
SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Susana Martinez
LICENSING EVALUATOR SIGNATURE: DATE: 02/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/21/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: GIRLS INCORPORATED OF CARPINTERIA
FACILITY NUMBER: 421712405
VISIT DATE: 02/21/2024
NARRATIVE
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A sampling of children and staff records were reviewed. LPA observed 5 children's files to be complete and current. LPA reviewed six staff records, 3 out of 6 are missing the mandated reporter certification training and immunization records. CPR/First Aid certification was verified, certification is valid through 5/4/24. Gloria states her personal file is inaccessible at this time, but can have it ready for review by the next day. LPA advised Gloria to email file to LPA.

During record review LPA discovered that S1 did not have a Criminal Record Clearance form on file. LPA asked Gloria about S1's position and job duties. Gloria states S1 occasionally assists with pick ups or subbing in for teachers on breaks. LPA interviewed S1 and asked if a criminal record clearance form has been received, S1 stated they thought so. S1 states she has been working at the facility for over a year. Gloria referenced Guardian and also observed that S1 is not on the facility roster. LPA verified S1 is not on roster either. LPA observed S1 leave the facility.

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.

Site supervisor was reminded that all adults 18 and over, including employees and volunteers, except 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.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP. CCC COMPLETED TESTING AND IS IN THE PROCESS OF REMEDIATING LEAD EXCEEDANCES. LPA observed the water source with lead exceedance to be completely off limits and not utilized for food prep or drinking water. Site is located inside the kitchen. Faucet was observed to be shut off and completely covered to prevent use.


Continued on 809-C
SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Susana Martinez
LICENSING EVALUATOR SIGNATURE:

DATE: 02/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2024
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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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: GIRLS INCORPORATED OF CARPINTERIA
FACILITY NUMBER: 421712405
VISIT DATE: 02/21/2024
NARRATIVE
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Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. 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/.

Site Supervisor was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

LPA Susana advised site supervisor Gloria Flores that this report dated 2/21/2024 documents One Type A citation which shall be posted for 30 consecutive days as there is/are immediate risk to the health, safety, or personal rights of children in care.

Also, LPA Martinez informed the site supervisor Gloria Flores to provide a copy of this licensing report dated 2/21/2024 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

Three deficiencies were cited today and can be found on the attached 809-D. One Type A and two Type B and a civil penalty of $500.

Two technical violations were also given during today's inspection.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.


Exit interview conducted, appeal rights were given and report was reviewed with the site supervisor Gloria Flores.
SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Susana Martinez
LICENSING EVALUATOR SIGNATURE:

DATE: 02/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2024
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Document Has Been Signed on 02/21/2024 04:25 PM - It Cannot Be Edited


Created By: Susana Martinez On 02/21/2024 at 03:38 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: GIRLS INCORPORATED OF CARPINTERIA
FACILITY NUMBER: 421712405

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/21/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
HSC
1596.871(c)(1)(A)
Administration of Child Day Care Licensing
Subsequent to initial licensure, a person specified in subdivision (b) who is not exempt from fingerprinting shall obtain either a criminal record clearance or an exemption from disqualification, pursuant to subdivision (f) of this section or Section 1522.7, from the State Department of Social Services prior to employment, residence, or initial presence in the facility.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, and record review, the licensee did not comply with the section cited above in one staff member (S1) does not have a criminal record clearance on file which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 02/21/2024
Plan of Correction
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Gloria asked S1 to leave the site. LPA observed S1 leave and advised both S1 and site supervisor that S1 cannot return until there is a criminal record clearance on file.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Ana Tolentino
LICENSING EVALUATOR NAME:Susana Martinez
LICENSING EVALUATOR SIGNATURE:
DATE: 02/21/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/21/2024


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Document Has Been Signed on 02/21/2024 04:25 PM - It Cannot Be Edited


Created By: Susana Martinez On 02/21/2024 at 03:38 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: GIRLS INCORPORATED OF CARPINTERIA
FACILITY NUMBER: 421712405

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/21/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.7995(a)(1)
General Provisions and Definitions
(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, and record review, the licensee did not comply with the section cited above in 3 out of 6 staff are missing immunization records which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/06/2024
Plan of Correction
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The center is to submit proof of immunizations to LPA by 03/06/24 via text, email or mail. LPA provided center with LPA's contact information.
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview and record review, the licensee did not comply with the section cited above in 3 out of 6 staff do not have a valid mandated reporter certification training certificate which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/06/2024
Plan of Correction
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The center is to submit proof of mandated reporter certificates to LPA by 03/06/24 via text, email or mail. LPA provided center with LPA's contact information.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Ana Tolentino
LICENSING EVALUATOR NAME:Susana Martinez
LICENSING EVALUATOR SIGNATURE:
DATE: 02/21/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/21/2024


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