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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426207287
Report Date: 09/08/2023
Date Signed: 09/08/2023 03:50:16 PM

Document Has Been Signed on 09/08/2023 03:50 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:SBCEO - LA HONDA STATE PRESCHOOLFACILITY NUMBER:
426207287
ADMINISTRATOR:JANELLE WILLISFACILITY TYPE:
850
ADDRESS:608 EAST CENTRAL AVENUETELEPHONE:
(805) 742-0433
CITY:LOMPOCSTATE: CAZIP CODE:
93436
CAPACITY: 26TOTAL ENROLLED CHILDREN: 26CENSUS: 0DATE:
09/08/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:45 PM
MET WITH:Belinda VajTIME COMPLETED:
04:00 PM
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On 09/08/23, Licensing Program Analyst (LPA) Francisca Velazquez made an unannounced Case Management inspection at the above Child Care Center (CCC). LPA met with Belinda Vaj, Associate Teacher of the CCC and discussed the purpose of the inspection, namely, the inspection was a follow up to a self reported incident involving C1 being bit by the class pet (guinea pig aka Otto) in the left pointer finger. LPA in the company of the Associate Teacher toured the interior and exterior of the CCC. LPA notes there were no children present at the time of this inspection.

LPA discussed the incident with the Associate Teacher who was present when the incident occurred. Associate teacher reported that Otto has been a part of the class since January of 2023. Per Associate Teacher, Otto was in his cage when C1 went to open the gate to pet Otto. C1 then walked up to Associate Teacher and informed teacher that C1 was bitten by Otto. Per Associate Teacher, C1 did not cry when the incident occurred. Staff (S1 and S2) at the CCC provided care to C1 immediately. In addition, The parent/guardian of C1 was immediately notified of the incident and was given the option to pick up C1 from the facility.

LPA communicated with parent of C1, who reported she has no concern regarding the incident that occurred in the CCC. Parent reported, C1 is well and returned to the CCC on 9/8/23. In addition, parent reported that CCC notified her immediately and gave her the option to pick up C1. Parent advised, C1 was picked up around 11:00am and C1 was in good spirits the entire day.

Based on the information obtained from Associate Teacher as well as parent of C1 and the LPA's observations, LPA determined there were no deficiencies and the CCC functioned in accordance with Title 22 regulations. Today, no deficiencies cited under Title 22 Division 12.

Notice of site visit was provided to the CCC and CCC was advised that it must remain posted for the next 30 days. .
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Francisca Velazquez
LICENSING EVALUATOR SIGNATURE: DATE: 09/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/08/2023
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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