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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 401700014
Report Date: 03/05/2025
Date Signed: 03/05/2025 03:27:39 PM

Document Has Been Signed on 03/05/2025 03:27 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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:CAPSLO - ATASCADERO HEAD STARTFACILITY NUMBER:
401700014
ADMINISTRATOR/
DIRECTOR:		KAREN EASTONFACILITY TYPE:
850
ADDRESS:965 EL CAMINO REALTELEPHONE:
(805) 466-2190
CITY:ATASCADEROSTATE: CAZIP CODE:
93422
CAPACITY: 40TOTAL ENROLLED CHILDREN: 40CENSUS: 14DATE:
03/05/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:50 PM
MET WITH:Karen EastonTIME VISIT/
INSPECTION COMPLETED:
03:50 PM
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On 3/5/25, at 1:50 PM, Licensing Program Analyst (LPA) Matthew Sapien made an unannounced Case Management inspection at the abovementioned Child Care Center (CCC). LPA met with Karen Easton, Site Supervisor of the CCC and explained the nature and purpose of the inspection. LPA, in the company of the Site Supervisor toured the interior and exterior of the CCC. LPA notes 14 children are in care, along with 4 teachers providing care and supervision.

The Case Management inspection follows an Unusual Incident at the CCC which occurred on 2/20/25. The Department was notified of the incident on 2/25/25 via email by the Area Manager of the CCC. The Area Manager is named Bobbie Sesena. During this instance, a child in care (C1) stated that a teacher at the facility (S1) hurt them during the transition to nap time. As stated in the report, two staff members (S2 and S3), one of whom was the Site Supervisor, were witnesses to the incident. The incident report did not include further details in relation to the incident.

During today's visit, LPA interviewed the following staff and children: S1, S2, S3 and C1.

S2 stated the following: S2 overheard C1 telling another child that S1 hurt them. The other child then asked C1, "who hurt you"? S2 noticed that C1 pointed towards S1. S2 then worked to settle down the children and room. S2 stated that it's not uncommon for C1 to say that staff are hurting C1 when they're not. S2 then followed up with S1 and S3 following the incident. S2 also asked each of these staff members to complete a Universal Contact Form documenting the incident. S1 also contacted Area Manager informing them of the incident. To clarify, S2 did not visually witness the incident firsthand.

S1 stated the following: Before the incident and during lunch time, C1 split another child's milk cup with his hand. S1 informed C1 to be careful causing C1 to become upset resulting in C1 throwing their own milk cup. S1 said that it's not okay to do that. C1 was then walked over from the lunch table to their cot for nap time. (CONT. LIC809-C, Page 2)

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Matthew Sapien
LICENSING EVALUATOR SIGNATURE: DATE: 03/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/05/2025
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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: CAPSLO - ATASCADERO HEAD START
FACILITY NUMBER: 401700014
VISIT DATE: 03/05/2025
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When S1 walked the child over, S1 grabbed the hand of C1. S1 repeated, "We're going to help you and touch your hands to keep you safe, okay?" When then touching the hands of C1, C1 stated "you're hurting me, you're hurting me." C1 eventually layed on the bed and S1 asked if they could touch C1's back to help fall asleep. C1 agreed and C1 eventually fell asleep 10 to 15 minutes thereafter.

S3 stated the following regarding the situation: There are challenges with this student. Behavioral teams within CAPSLO are aware of C1 and their trying to support him and the family. S3 witnessed the incident and stated that S1 simply guided C1 to C1's cot after the challenging situation.

Prior to conducting the interview with C1, LPA confirmed that the child was fit to answer questions because C1 was able to discern the difference between a truth and lie. During the interview, C1 stated the following: C1 likes attending day care, C1 enjoys nap time, C1 likes staff members, and that staff don't hurt C1 in any way.

Based on record review and the aforementioned interviews, LPA gathered that the incident was not a violation of personal rights to said child and that no further action is needed.



During today's visit, no deficiencies were issued. Site Supervisor was provided a copy of their Appeal Rights (LIC 9058) and their signature on this form acknowledges receipt of these rights.

An exit interview was conducted with Facility Representative Karen Easton. Facility Representative was provided with a Notice of Site Visit (LIC 9213). Notice of Site Visit must be posted for 30 days or a civil penalty of $100 may apply.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Matthew Sapien
LICENSING EVALUATOR SIGNATURE:

DATE: 03/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/05/2025
LIC809 (FAS) - (06/04)
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