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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426215141
Report Date: 03/16/2023
Date Signed: 03/16/2023 04:43:33 PM

Document Has Been Signed on 03/16/2023 04:43 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
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:SBCEO - SANTA MARIA CAL SAFEFACILITY NUMBER:
426215141
ADMINISTRATOR:JANELLE WILLISFACILITY TYPE:
850
ADDRESS:829 SOUTH LINCOLNTELEPHONE:
(805) 925-2567
CITY:SANTA MARIASTATE: CAZIP CODE:
93454
CAPACITY: 15TOTAL ENROLLED CHILDREN: 15CENSUS: 7DATE:
03/16/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:45 PM
MET WITH:Brittany WellsTIME COMPLETED:
05:00 PM
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On 3/16/23, Licensing Program Analyst (LPA) Francisca Velazquez conducted a case management inspection in regards to an Unusual Incident Report (UIR) received by the Department on 2//2/23. LPA met with Brittany Wells, Site Supervisor of the Child Care Center (CCC), and explained the purpose of today's inspection. The unusual incident reported specifically involved potential violations with diapering of children in the CCC.

LPA and Site Supervisor toured the interior and exterior of the facility. LPA notes there were seven (7) children in the CCC being cared and supervised by four (4) staff. LPA requested children roster with parent contact information, staff roster, diaper changing procedure and daily health logs for children in the CCC.

During today's inspection no deficiency cited. LPA will continue to follow up on this incident.

Exit interview and review of report was conducted with Site Supervisor, Brittany Wells. Notice of site visit was provided and must remain posted for 30 days.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Francisca Velazquez
LICENSING EVALUATOR SIGNATURE: DATE: 03/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/16/2023
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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