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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426215638
Report Date: 10/12/2022
Date Signed: 10/12/2022 02:06:42 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 10/12/2022 02:06 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:PROVIDENCE PRESCHOOLFACILITY NUMBER:
426215638
ADMINISTRATOR:DESIREE FELLERFACILITY TYPE:
850
ADDRESS:3225 CALLE PINONTELEPHONE:
(805) 962-3091
CITY:SANTA BARBARASTATE: CAZIP CODE:
93105
CAPACITY: 72TOTAL ENROLLED CHILDREN: 72CENSUS: 63DATE:
10/12/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Desiree FellerTIME COMPLETED:
02:05 PM
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On October 12th, 2022 at 11:45AM, Licensing Program Analyst (LPA) Rosie Breault conducted an unannounced Annual/Random inspection. LPA met with facility director Desiree Feller and advised her the purpose of the inspection. LPA conducted a Covid-19 prescreening and no exposure on site. Director provided LPA a tour of the facility inside and out. The center operates from 8:15AM-2:45PM Monday thru Friday. There were 63 children in care at the time of the inspection, and 14 teachers.

LPA observed required licensing documents, and a daily schedule mounted on the wall at the entrance of the facility. Children bring their own lunches, snack, water bottles from home, and facility provides filtered water filling stations both inside and out. Each of the classrooms have age appropriate toys and furniture readily accessible for children in care. The facility uses an an electronic sign in and out sheet. There are four (4) classrooms being used. Facility uses three bathrooms all are were found to be clean, functioning properly, and with ample toilets and sinks. The outdoor area has an ample amount of space for children to play with appropriate toys and a shaded area.

Incidental medical services are being provided and LPA observed medications for two children to be locked away, inaccessible to children, with unaltered labels in separate prescription boxes, and not expired. Located with the medications, were completed licensing forms and doctor’s instructions and information was up to date.

CONTINUED ON LIC809C

SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Maryrose Breault
LICENSING EVALUATOR SIGNATURE: DATE: 10/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/12/2022
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: PROVIDENCE PRESCHOOL
FACILITY NUMBER: 426215638
VISIT DATE: 10/12/2022
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A sampling of children and staff records were reviewed. LPA observed children's files to be complete and current. LPA observed staff files to be complete and current. LPA verified SB792 Child Care Adult Immunization and Tuberculosis requirements. Teachers meet the required qualifications. Teacher present has a current Pediatric CPR/First-Aid certificates that is valid until 8/13/2023. All teachers have current Mandated Reporter certificates. Facility is currently following Covid-19 guidelines.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation interpretations and procedures for Child Care Centers sections 101173 and 101226. When any IMS is provided, an updated plan of operation that includes IMS must be submitted to the Department. the follow information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA information line at (800) 514-0301 (voice) / (800) 514-0383 (TTY) and link to publication: Commonly asked questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

No deficiencies were cited during today’s visit.

A Notice of Site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Director.

SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Maryrose Breault
LICENSING EVALUATOR SIGNATURE:

DATE: 10/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2022
LIC809 (FAS) - (06/04)
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