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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 401702641
Report Date: 11/20/2024
Date Signed: 11/20/2024 02:49:49 PM

Document Has Been Signed on 11/20/2024 02:49 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:ORFALEA FAMILY & ASI CHILDREN'S CENTER RM # 133FACILITY NUMBER:
401702641
ADMINISTRATOR/
DIRECTOR:		ASHLEY SHOALSFACILITY TYPE:
850
ADDRESS:1 GRAND AVE RM#. #133TELEPHONE:
(805) 756-1267
CITY:SAN LUIS OBISPOSTATE: CAZIP CODE:
93407
CAPACITY: 96TOTAL ENROLLED CHILDREN: 96CENSUS: 55DATE:
11/20/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:46 PM
MET WITH:Ashley ShoalsTIME VISIT/
INSPECTION COMPLETED:
03:00 PM
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On 11/20/24, at 12:46 PM, Licensing Program Analysts (LPAs) Shane Loftus and Elvin Baddley conducted an unannounced Annual Random Inspection the above-mentioned Child Care Center (CCC). LPAs met with Ashley Shoals, Director of the CCC and explained the purpose of the inspection. LPAs, in the company of Director, toured the interior and exterior of the CCC. The CCC operates from 7:30 AM to 5:30 PM, Monday - Friday. The preschool uses three classrooms for child care. LPAs observed 55 children during the inspection, along with 12 teachers (cleared and associated) providing care and supervision. The facility is an infant/preschool combination center and the infant program maintains a separate license (#401702793).

The classrooms of the CCC are clean and organized. Each classroom has appropriate toys and furnishings available for children in care. The CCC has an operable carbon monoxide detector which was tested (12:30 PM). The bathrooms in the CCC are attached to the classrooms. LPAs observed the bathrooms to be in safe and sanitary operating condition. LPAs observed multiple refrigerators in the kitchen of the CCC. The refrigerator contained items for the childrens consumption. LPAs note the CCC provided snacks, breakfast, and lunches for children in care. The facility has water available for the children to access inside of the CCC and in the outdoor play yard. Water sources at the CCC have been tested for lead contaminants.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1- CCP). LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

LPAs also observed a posted menu near the CCC entry door. Disinfectants, cleaning solutions, medications and sharps are stored on elevated shelves in classroom cabinets which are beyond the reach of children in care and inaccessible. Continued 809-C

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Shane Loftus
LICENSING EVALUATOR SIGNATURE: DATE: 11/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/20/2024
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: ORFALEA FAMILY & ASI CHILDREN'S CENTER RM # 133
FACILITY NUMBER: 401702641
VISIT DATE: 11/20/2024
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The CCC also has cleaning supplies in the kitchen area which is excluded from care and inaccessible to children in care. LPA observed licensing required forms, documents and notices posted at the CCC. LPAs reviewed Sign In/Out forms at the CCC. The CCC uses the Care Connect Provider Application containing the arrival and departure times of children along with the signature of authorized representatives.

The CCC outdoor play areas are attached to each classroom. Yards 5, 6, and 7 are used for the Pre K program. The areas are enclosed by a combination of chain linked slated and cider block fencing. The footing in the areas are varied. The play yards fences' entry/exit gates are secured. LPAs observed age-appropriate toys and play equipment in the play areas. The toys and play equipment are in suitable condition and free of sharp, loose, or pointed objects. The play structures in the areas have adequate cushioning to absorb falls. LPA reminded the Director to replace toys and play equipment when such items begin to degrade and are not in good repair. LPAs observed an abundance of shade created by trees, shade sails and building overhangs in the play yards. LPAs observed no bodies of water on site. Waste receptacles with tight fitting covers are observed throughout the center.



A sampling of staff and children's records were reviewed. The children’s records were complete and found to contain emergency contact information as well as immunization records. Staff records were reviewed and contained current pediatric First Aid/CPR certifications (EMSA Approved) as well as certifications for Mandated Reporter. Director informed LPA no firearm or ammunition is stored on the premises.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of “medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see PIN 22-02-CCP. 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 are available at: https://www.ada.gov/resources/child-carecenters/.

Director was reminded that all adults 18 and over, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.
Continued on 809-C
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Shane Loftus
LICENSING EVALUATOR SIGNATURE:

DATE: 11/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/20/2024
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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: ORFALEA FAMILY & ASI CHILDREN'S CENTER RM # 133
FACILITY NUMBER: 401702641
VISIT DATE: 11/20/2024
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Director was informed of the MyChildCarePlan.org website; 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.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

No deficiencies were cited during today’s inspection. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Facility representative Ashley Shoals
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Shane Loftus
LICENSING EVALUATOR SIGNATURE:

DATE: 11/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/20/2024
LIC809 (FAS) - (06/04)
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