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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426211959
Report Date: 12/12/2024
Date Signed: 12/12/2024 12:01:23 PM

Document Has Been Signed on 12/12/2024 12:01 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
CENTRAL COAST-CHILD, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:UNIVERSITY CHILDREN'S CENTERFACILITY NUMBER:
426211959
ADMINISTRATOR/
DIRECTOR:		ANNETTE MUSEFACILITY TYPE:
850
ADDRESS:STUDENT RESOURCE BLDG. UCSBTELEPHONE:
(805) 893-3665
CITY:SANTA BARBARASTATE: CAZIP CODE:
93106
CAPACITY: 26TOTAL ENROLLED CHILDREN: 26CENSUS: 20DATE:
12/12/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:55 AM
MET WITH:Marina NolteTIME VISIT/
INSPECTION COMPLETED:
12:10 PM
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
On December 12, 2024 Licensing Program Analyst (LPA) Giovani Gonzalez conducted an unannounced Case Management - Incident inspection at the above-mentioned Child Care Center. LPA met Program Coordinator Marina Nolte and informed them the purpose of the inspection was to follow up on a self reported incident that occurred on 12/3/2024.

On 12/3/2024, Staff 1 (S1) noticed Child 1 (C1) laying down and crying next to a round children's table. After S1 helped C1 and S1 noticed C1 was bleeding from above the right eye. Staff 2 who was also near the C1, comforted the child, stopped the bleeding and applied the an ice pack over the injury. Once C1 was calm both parents were notified of the incident and were requested to take a look at the injury to decide if they wanted to take child to urgent care. C1 was taken to urgent care by parent where C1 received surgical glue over the injury. Per Program Coordinator C1 returned to the CCC the next day.

During the inspection LPA observed the area where the incident occurred and did not observe any hazards. LPA observed the turf to be level and the table to be age appropriate.

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

No deficiencies were cited as a result of the incident.

Exit interview conducted and report was reviewed with the Program Coordinator Marina Nolte.

A notice of site visit was given.


SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Giovani Gonzalez
LICENSING EVALUATOR SIGNATURE: DATE: 12/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/12/2024
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 1