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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 401710899
Report Date: 08/29/2024
Date Signed: 08/29/2024 12:50:33 PM

Document Has Been Signed on 08/29/2024 12:50 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:DEL MAR ELEMENTARY SCHOOL - KID'S CLUBFACILITY NUMBER:
401710899
ADMINISTRATOR/
DIRECTOR:
ANGELICA GALLARDOFACILITY TYPE:
840
ADDRESS:501 SEQUOIA, ROOM 25TELEPHONE:
(805) 772-6278
CITY:MORRO BAYSTATE: CAZIP CODE:
93442
CAPACITY: 50TOTAL ENROLLED CHILDREN: 50CENSUS: 0DATE:
08/29/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:45 AM
MET WITH:Angelica Gallardo and Kristina VegaTIME VISIT/
INSPECTION COMPLETED:
01:00 PM
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On 8/29/24, at 9:45 AM, Licensing Program Analysts (LPAs) Elvin Baddley and Matthew Sapien conducted an unannounced Annual/Random inspection of the abovementioned Child Care Center (CCC). LPAs met with Angelica Gallardo, Director of the CCC and Kristina Vega, Assistant Director. LPA explained the purpose and nature of the inspection. LPAs, in the company of the Assistant Director, toured the interior and exterior of the CCC. The CCC is located in a module classroom on the grounds of Del Mar Elementary School. The CCC operates from 7:00 AM to 8:25 AM and 2:50 PM to 6:00 PM, Monday - Friday. At the time of inspection, LPAs observed no children in care on site.

The classroom of the CCC is clean and orderly. The classroom has age appropriate equipment and furnishings available to children in care. LPAs observed a carbon monoxide detector in classroom which was tested at 10:08 AM and found to be operable. There are 3 restrooms used by the children in care. All restrooms are in sanitary operating condition. LPAs observed an operable refrigerator in the classroom which contained food for the children. The CCC provides snacks to children in care. Lunch is not provided to children in care. The CCC also has available drinking water for children inside and outside of the facility.
CCCs constructed before 1/1/20, to test their water (used for drinking and food preparation) for lead contamination before 1/1/23, and then every 5-years except after the date of the first test. For child care center licenses issued after 7/1/22, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP). LPAs verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

Disinfectants and cleaning solutions are observed in a locked cabinet underneath a sink in the CCC The CCC's medications and sharps are stored the CCC's office which is inaccessible to children in care. LPAs observed required licensing forms and documents posted near the main door entry. A posted menu is also posted in a visible location. The CCC's Sign In/Out forms were reviewed by LPAs. The forms contained the arrival and departure times of children in care and well as the signatures of the children's authorized
(CONT. 809-C, Page 2)
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE: DATE: 08/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/29/2024
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
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: DEL MAR ELEMENTARY SCHOOL - KID'S CLUB
FACILITY NUMBER: 401710899
VISIT DATE: 08/29/2024
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representatives.

The CCC outdoor playground areas are enclosed by chain linked fencing. The fence’s entry/exit gates are secured. LPAs observed age appropriate toys/play equipment in the play areas. The toys/play equipment are free of sharp, loose or pointed objects. The play structures in the playground areas have adequate cushioning materials to absorb falls. No bodies of water are observed on site. LPAs notes a fenced play yard is also outside of the classroom which is also for outdoor activities. At the time of the inspection, the aforementioned area is closed and in need the process of renovations. LPAs reminded Director and Assistant Director to contact CCLD at the conclusion of renovations in order to inspect the area for use.

A sampling of staff and children records were reviewed. The children’s records were complete and found to contain emergency contact information, among other required license documentation and forms. Staff records were reviewed and contained documentation to support Pediatric CPR/First Aid and Mandated Reporter training among other required license documentation and forms. Director notes no firearms or ammunition are stored on site.

This facility provides Incidental Medical Services – IMS. LPAs 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-care-centers/.

Facility representative was reminded that all adults 18 and over, including employees and volunteers,
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.

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
(CONT. 809-C, Page 3)
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE:

DATE: 08/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2024
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: DEL MAR ELEMENTARY SCHOOL - KID'S CLUB
FACILITY NUMBER: 401710899
VISIT DATE: 08/29/2024
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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.

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 Angelica Gallardo.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE:

DATE: 08/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2024
LIC809 (FAS) - (06/04)
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