426211744-5-21-2026-17-CC-EGEE-DUARW2-20260521132227

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 426211744
Report Date: 05/21/2026
Date Signed: 05/21/2026 01:22:32 PM

Document Has Been Signed on 05/21/2026 01:22 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:	CAC - WESTGATE CENTER		FACILITY NUMBER:	426211744
ADMINISTRATOR/ DIRECTOR:	ADRIANA RODRIGUEZ		FACILITY TYPE:	850
ADDRESS:	1240 W. BETHEL LN. #1A		TELEPHONE:	(805) 347-8400
CITY:	SANTA MARIA	STATE: CA	ZIP CODE:	93458
CAPACITY: 72	TOTAL ENROLLED CHILDREN: 72	CENSUS: 32	DATE:	05/21/2026
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	12:10 PM
MET WITH:	Carla Ayala		TIME VISIT/ INSPECTION COMPLETED:	01:37 PM

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On May 21, 2026, at 12:10 PM, Licensing Program Analyst (LPA) Elizabeth George conducted an unannounced Case Management inspection. LPA met with Site Supervisor Carla Ayala and discussed the purpose of the inspection, which was to follow up on an incident reported to the Department on 4/1/26, as required, as well as an incident reported on 3/19/26. LPA, in the company of the Site Supervisor, toured the facility inside and outside. During the inspection, LPA observed six staff providing care and supervision to 32 children.

Regarding the incident reported on 4/1/26: At approximately 11:00 AM, a child was playing on the giant foam blocks and was observed throwing themselves onto the larger blocks with significant force. The teacher observed the behavior, removed the larger blocks, and allowed the child to continue playing with the smaller ones. The child continued the rough play and landed on their elbow at a 45-degree angle. The child displayed tenderness in the arm. Staff informed the parent of the incident and advised that the child be taken for medical evaluation.

Regarding the incident reported on 3/19/26: Child 2 was playing independently with a plastic bat when Child 1 approached, took the bat from Child 2, and struck Child 2 on the head. Child 2 sustained a small red mark. Staff separated the children, spoke with them, and informed their parents of the incident.

Based on the information gathered during the inspection, LPA determined that staff took appropriate action to meet the needs of the children in care.

No deficiencies were cited as a result of this inspection. Exit interview was conducted, Notice of Site Visit was provided, and the report was reviewed with Site Supervisor, Carla Ayala.

NAME OF LICENSING PROGRAM MANAGER: Ana Tolentino
NAME OF LICENSING PROGRAM ANALYST: Elizabeth George
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/21/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2026

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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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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