426207338-12-22-2023-17-CC-MBRT-CJWQFE-20221005120749

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 426207338
Report Date: 10/05/2022
Date Signed: 12/22/2023 10:46:42 AM

Document Has Been Signed on 12/22/2023 10:46 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
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME:	STORYTELLER CHILDREN'S CENTER		FACILITY NUMBER:	426207338
ADMINISTRATOR:	JAQUELINE MCDONOUGH		FACILITY TYPE:	850
ADDRESS:	2115 STATE ST.		TELEPHONE:	(805) 682-9585
CITY:	SANTA BARBARA	STATE: CA	ZIP CODE:	93105
CAPACITY: 42	TOTAL ENROLLED CHILDREN: 42	CENSUS: 12	DATE:	10/05/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:57 AM
MET WITH:	Myra Lopez		TIME COMPLETED:	12:30 PM

NARRATIVE

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The purpose of this amendment is to update the administrator's name.

On October 5^th, 2022 at 8:57am, Licensing Program Analyst (LPA) Rosie Breault conducted a Required Annual inspection. LPA met with site supervisor Myra Lopez and explained the purpose of the inspection. LPA asked Covid-19 screening questions prior to entering the facility and no exposure on site. LPA conducted a tour of the facility inside and out. There were twelve (12) children in care at the time of the inspection and three (3) staff. At the commencement of the tour, Program Director Jacqueline McDonough arrived. The center operates from 7:30 AM to 5:00 PM and is open Monday thru Friday.

Licensing required notices were posted prominently at the front entrance and inside the front office. Center uses written sign in sheet. The facility uses two classrooms with the toddler classroom currently closed at this time. Bathrooms and classrooms were observed to be clean and inaccessible of toxins. There is water inside and outside for the children to have access too. Classroom(s) have age appropriate toys and furniture available for children. The facility provides cots for napping and linens are kept separate from one another. The facility provides food to children and LPA observed the posted menu. There is a functioning carbon monoxide and smoke detector that meets statutory requirement. The last fire drill was conducted on 9/6/2022. First aid kits are available in both classrooms, labeled and inaccessible to children. Facility provides incidental medical services. In a labeled, locked box located in the closet of the PK room, LPA observed two (2) nebulizers and three (3) inhalers with no identifying paperwork. Site supervisor indicated one (1) nebulizer belongs to a child, but unable to confirm the affiliation of the remaining four (4). This is out of compliance with California Code of Regulation, Division 12 101226 (e) (2). Type B deficiency is being cited on the attached LIC809D.

CONTINUED ON LIC809C

SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Susana Martinez
LICENSING EVALUATOR SIGNATURE:	DATE: 10/05/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/05/2022

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: STORYTELLER CHILDREN'S CENTER	FACILITY NUMBER: 426207338
	VISIT DATE: 10/05/2022

NARRATIVE

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The outdoor playground is completely enclosed by a fence. The playground has an ample amount of shade available and age appropriate toys/equipment. LPA observed one bottle of “Fantastix” cleaning spray on the outdoor preschool table accessible to children. This is out of compliance with California Code of Regulation, Division 12 101238.4 (d). Type A deficiency is being cited on the attached LIC809D.

A sampling of children and staff records were reviewed and found current. At least one staff present has current Pediatric First Aid/CPR certificates that expires on 3/12/2024. Teachers present have current AB 1207 Mandated Reporter Training certificates on file.

LPA informed director that this report dated 10/5/2022, Type A citation shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children.

LPA informed director to provide a copy of this licensing report dated 10/5/2022 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.

Licensee was reminded that all adults 18 and over, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

CONTINUED ON LIC809C

SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Maryrose Breault
LICENSING EVALUATOR SIGNATURE:	DATE: 10/05/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/05/2022

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: STORYTELLER CHILDREN'S CENTER	FACILITY NUMBER: 426207338
	VISIT DATE: 10/05/2022

NARRATIVE

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This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process.

A Notice of Site Visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the director Jacqueline McDonough.

Appeal rights were provided to director.

SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Maryrose Breault
LICENSING EVALUATOR SIGNATURE:	DATE: 10/05/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/05/2022

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 10/05/2022 12:08 PM - It Cannot Be Edited

Created By: Maryrose Breault On 10/05/2022 at 11:41 AM

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: STORYTELLER CHILDREN'S CENTER	FACILITY NUMBER: 426207338
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/05/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type A

Section Cited

CCR

101238.4(d)

Combustibles, cleaning equipment and cleaning agents shall be stored in an area separate from food supplies, in a locked cabinet or in a location innacessible to children. This was met by evidence of:
	Deficient Practice Statement
1 2 3 4	Based on LPA observation, the licensee did not comply with the section cited above in one count which poses an immediate health, safety or personal rights risk to persons in care.
	POC Due Date: 10/10/2022
	Plan of Correction
1 2 3 4	Licensee will provide a photographic documentation of the location of all cleaning compounds and toxins that are in compliance with the regulation.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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:

Maryrose Breault

LICENSING EVALUATOR SIGNATURE:

DATE: 10/05/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/05/2022

LIC809 (FAS) - (06/04)

Page: 4 of 5

Document Has Been Signed on 10/05/2022 12:08 PM - It Cannot Be Edited

Created By: Maryrose Breault On 10/05/2022 at 11:46 AM

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: STORYTELLER CHILDREN'S CENTER	FACILITY NUMBER: 426207338
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/05/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101226(e)(2)

In centers where the licensee chooses to handle medications: all prescription and non-prescription medications shall be maintained with the child's name and shall be dated.
	Deficient Practice Statement
1 2 3 4	Based on LPAs observation, the licensee did not comply with the section cited above in 5 counts which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 10/10/2022
	Plan of Correction
1 2 3 4	Licensee to immediately label, name, date and provide medical instructions all prescription and non-prescription medications that are provided to children and present documentation to LPA.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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:

Maryrose Breault

LICENSING EVALUATOR SIGNATURE:

DATE: 10/05/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/05/2022

LIC809 (FAS) - (06/04)

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