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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426212030
Report Date: 03/04/2021
Date Signed: 12/22/2023 09:44:25 AM

Document Has Been Signed on 12/22/2023 09:44 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:
426212030
ADMINISTRATOR:ALICIA JIMENEZFACILITY TYPE:
850
ADDRESS:2121 DE LA VINATELEPHONE:
(805) 687-4540
CITY:SANTA BARBARASTATE: CAZIP CODE:
93105
CAPACITY: 45TOTAL ENROLLED CHILDREN: 45CENSUS: 6DATE:
03/04/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:05 PM
MET WITH:Alicia JimenezTIME COMPLETED:
03:40 PM
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The purpose of this amendment is to update the administrator's name.

On March 4, 2021 at 1:12 PM, Licensing Program Analyst (LPA) Francisco Pedroza, LPA Laura Villanueva, and Investigator Tiffany Brunelli conducted an unannounced case management inspection. LPAs and Investigator met with facility Site Supervisor Alicia Jimenez and advised the purpose of the inspection. Site Supervisor provided LPA Villanueva a tour of the facility. There were six children in care at the time of the inspection.



On February 26, 2021, Community Care Licensing (CCL) was informed of an incident that occurred off site during a field trip with another local company on February 5, 2021. LPAs and Investigator conducted staff interviews and record reviews. Due to insufficient information available at this time, the incident requires further investigation.
SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Susana Martinez
LICENSING EVALUATOR SIGNATURE: DATE: 03/04/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/04/2021
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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