<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426207338
Report Date: 05/24/2023
Date Signed: 12/22/2023 10:43:07 AM

Document Has Been Signed on 12/22/2023 10:43 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: 14DATE:
05/24/2023
TYPE OF VISIT:Case Management - Legal/Non-complianceUNANNOUNCEDTIME BEGAN:
08:20 AM
MET WITH:Jacqueline McDonoughTIME COMPLETED:
09:26 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
The purpose of this amendment is to update the administrator's name.

On May 24th, 2023, at 8:21am Licensing Program Analyst (LPA) Rosie Breault conducted a Case Management - Legal inspection to ensure compliance per 11/1/2022 facility plan. LPA was greeted by enrollment coordinator Analu Diaz and LPA was informed Director or site supervisor was not present on the property, only four (4) teachers for care and supervision. Ms. Diaz contacted Jaqueline McDonough, Program Director and LPA waited for her arrival. At approximately 8:43am Program Director arrived and provided LPA a tour of the facility. At the time of the inspection there were fourteen (14) children and four (4) 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, identifying information and forms present.

Title 22 Division 12 requires child care center Director to be present on site at all times, and if absent, a designated fully qualified teacher may act on behalf. Program Director informed LPA that she is the designated responsible party. LPA reviewed Designation of Facility Responsibly (LIC308) and confirmed information provided. A Type B citation has been issued.

Exit interview conducted, report review, copy and Appeal Rights provided to Program Director.

Corresponding citation on LIC809D.

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: 05/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/24/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
Document Has Been Signed on 05/24/2023 09:24 AM - It Cannot Be Edited


Created By: Maryrose Breault On 05/24/2023 at 09:09 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: 05/24/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/31/2023
Section Cited
CCR
101215.1(f)

1
2
3
4
5
6
7
When the child care center director is absent from the center, arrangements shall be made for a fully qualified teacher as specified in Section 101216.1(c) to act as substitute…and shall be designated as an authorized person to correct operational deficiencies that constitute immediate threats to children's health and safety.
1
2
3
4
5
6
7
Program Director to provide updated LIC308 (Designation of Facility Responsibility) to LPA via email: maryrose.breault@dss.ca.gov by May 31st, 2023.
8
9
10
11
12
13
14
This evidence is met by:
Program Director verbal statement to LPA and LPA review of LIC308
8
9
10
11
12
13
14

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
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: 05/24/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/24/2023


LIC809 (FAS) - (06/04)
Page: 2 of 2