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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426207338
Report Date: 03/22/2023
Date Signed: 12/22/2023 10:44:29 AM

Document Has Been Signed on 12/22/2023 10:44 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 CENTERFACILITY NUMBER:
426207338
ADMINISTRATOR:JAQUELINE MCDONOUGHFACILITY TYPE:
850
ADDRESS:2115 STATE ST.TELEPHONE:
(805) 682-9585
CITY:SANTA BARBARASTATE: CAZIP CODE:
93105
CAPACITY: 42TOTAL ENROLLED CHILDREN: 42CENSUS: 18DATE:
03/22/2023
TYPE OF VISIT:Case Management - Legal/Non-complianceUNANNOUNCEDTIME BEGAN:
10:41 AM
MET WITH:Myra LopezTIME COMPLETED:
11:32 AM
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The purpose of this amendment is to update the administrator's name.

On March 22nd, 2023, at 10:41AM Licensing Program Analysts (LPA) Rosie Breault and Daniel Venegas conducted a Case Management- Legal inspection to ensure compliance per 11/1/2022 facility plan. LPAs met with site supervisor Myra Lopez and informed her of the nature and purpose of the inspection. A Covid 19 assessment was asked, and site supervisor indicated no exposure on site. At the time of the inspection there were eighteen (18) children and three (3) staff.

LPAs observed children to be under care and supervision. Sharps, poisons, combustibles, and any other toxins which may pose a threat to children were rendered inaccessible at the time of the inspection. Children’s medications were stored in a locked box inaccessible in a closet, with unaltered labels, non-expired, and required names and forms present.

No deficiencies were cited during today’s inspection.

Exit interview conducted, report review and copy provided to site supervisor Myra Lopez.

THE NOTICE OF SITE VISIT WAS POSTED AS REQUIRED BY H&S CODE SEC. 1596.817. THE NOTICE OF SITE VISIT MUST REMAIN POSTED FOR 30 DAYS OR A CIVIL PENALTY OF $100.00 WILL APPLY.

SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Susana Martinez
LICENSING EVALUATOR SIGNATURE: DATE: 03/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/22/2023
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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