426216651-8-4-2023-17-CC-SMAZ-CUDQ2U-20230804114743

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 426216651
Report Date: 08/04/2023
Date Signed: 08/04/2023 11:47:49 AM

Document Has Been Signed on 08/04/2023 11:47 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:	ORCUTT UNION SCHOOL DISTRICT		FACILITY NUMBER:	426216651
ADMINISTRATOR:	JOSEPH DANA		FACILITY TYPE:	850
ADDRESS:	255 WINTER ROAD		TELEPHONE:	(805) 938-8930
CITY:	SANTA MARIA	STATE: CA	ZIP CODE:	93455
CAPACITY: 24	TOTAL ENROLLED CHILDREN: 24	CENSUS: 0	DATE:	08/04/2023
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Michelle Valencia		TIME COMPLETED:	12:02 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	This is a change of location from facility number: 426207752. On August 4, 2023 Licensing Program Analyst (LPA) Susana Martinez conducted an announced pre-licensing inspection for a change of location. LPA met with site supervisor Michelle Valencia and advised her of the purpose for the inspection. Together with the site supervisor, LPA toured the facility inside and outside. At the time of inspection there were no children in care and no other adults present. The center plans on running two day programs; the first one from 8:30 AM- 11:30 AM and the second one from 12 PM- 3 PM. The center plans on operating as of 8/9/2023. The program will be utilizing one room labeled K1 on the Joe Nightingale Elementary School campus. The room was observed to have age-appropriate toys and learning materials. The center will be utilizing Learning Genie for sign-in/sign-out. At 10am, LPA observed site supervisor test the carbon monoxide detector which was found to be in working condition. Fire extinguishers were observed to be located at the entrance of both doors. Disinfectants and cleaning solutions are located above the sink which are inaccessible to children. Site supervisor states the children will not nap due to half day program, therefore napping equipment is not necessary. A first aid kit was observed to be readily accessible for use. The room has one toilet and three sinks. A waiver request was approved for CCR, Title 22, Division 12, Section 101239(h) Fixtures, Furniture, Equipment and Supplies. The restroom waiver was granted and is valid with the following conditions: - Children are to be escorted to and from the restroom by an adult staff member and/or the facility shall maintain a 1:12 teacher child ratio at all times. - Staff member shall ensure that the restroom is unoccupied and shall remain outside or at the entrance of the restroom while it is in use. - At no time, preschool children can be commingled with school-age children. - Any changes shall be reported to the licensing agency immediately. - Waiver shall be posted next to the license during business hours. - Licensee shall ensure no interference with functions of daily living including eating, sleeping or toileting at all times. Continued on 809-C

SUPERVISORS NAME: George Mingle
LICENSING EVALUATOR NAME: Susana Martinez
LICENSING EVALUATOR SIGNATURE:	DATE: 08/04/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/04/2023

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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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: ORCUTT UNION SCHOOL DISTRICT	FACILITY NUMBER: 426216651
	VISIT DATE: 08/04/2023

NARRATIVE

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The School District will be providing meals to the children in care. LPA asked site supervisor how the center plans on providing drinking water to children in care. Michelle states the center will be using the water faucets located inside and outside as well as using filtered water from a Brita. LPA advised Michelle that Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010 to test their drinking water for lead contamination. Michelle confirmed with the head of maintenance and operations personnel that the building was constructed in 2017, therefore lead testing is not required at this time.

The outdoor activity space has ample space and sufficient shade. The play equipment and materials were observed to be age appropriate and in good condition. Cushioning material underneath the climbing equipment was observed to be in good repair. LPA reminded Michelle that the outdoor activity space shall be free of any trash and all trash cans shall have a tight fitted lid per CCR, Title 22, Division 12, Section 101239(f)(1). Michelle states the center plans on sharing the outdoor activity space with the school-age school children. LPA reminded Michelle that the preschool program children must have a completely separate outdoor activity space to prevent commingling. Michelle stated there is a schedule in place to prevent commingling. LPA advised Michelle that a waiver request is needed for the outdoor play yard.

Site Supervisor was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5-days or, if the penalty is for a repeat violation, for a maximum of 30-days per person will be assessed if this regulation is violated. LPA provided a copy of a livescan form and a transfer request form.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (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. LPA observed a locked storage space for any potential medication required by children in care.

Continued on 809-C

SUPERVISORS NAME: George Mingle
LICENSING EVALUATOR NAME: Susana Martinez
LICENSING EVALUATOR SIGNATURE:	DATE: 08/04/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/04/2023

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: ORCUTT UNION SCHOOL DISTRICT	FACILITY NUMBER: 426216651
	VISIT DATE: 08/04/2023

NARRATIVE

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LPA reviewed with site supervisor the LIC 311A, Records to Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted.

Site supervisor was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

License is pending:
- Approval of outdoor staggered play schedule waiver request.

Once outdoor waiver request is approved, the center meets the requirements for 24 children.

A notice of site visit was given to site supervisor and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

Exit interview conducted and report was reviewed with the site supervisor Michelle Valencia.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms.
To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

SUPERVISORS NAME: George Mingle
LICENSING EVALUATOR NAME: Susana Martinez
LICENSING EVALUATOR SIGNATURE:	DATE: 08/04/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/04/2023

LIC809 (FAS) - (06/04)

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