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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 401711512
Report Date: 04/06/2026
Date Signed: 04/06/2026 01:52:28 PM

Document Has Been Signed on 04/06/2026 01:52 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 - PASO ROBLES HEAD STARTFACILITY NUMBER:
401711512
ADMINISTRATOR/
DIRECTOR:		BRANDY BLACKBURN-HERNDONFACILITY TYPE:
850
ADDRESS:304-19TH STREETTELEPHONE:
(805) 238-5323
CITY:PASO ROBLESSTATE: CAZIP CODE:
93446
CAPACITY: 56TOTAL ENROLLED CHILDREN: 56CENSUS: 0DATE:
04/06/2026
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:30 PM
MET WITH:Makala GardnerTIME VISIT/
INSPECTION COMPLETED:
02:30 PM
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On 4/6/26, at 12:30 PM, Licensing Program Analyst (LPA) Matthew Sapien made an unannounced Case Management inspection at the abovementioned Child Care Center (CCC). LPA met with Makala Gardner, Facility Representative of the CCC, and explained the nature and purpose of the inspection. LPA, in the company of the Facility Representative, toured the CCC. At the time of the inspection, LPA observed no children in care, as there are physical plant disruptions (electrical issues). The Facility Representative anticipates that the CCC will reopen later this week. In addition to the Facility Representative of the CCC, LPA also observed 14 other staff assistants present on site (cleared and associated). Importantly to note, the CCC is on the grounds of Glen Speck Elementary School.

This Case Management inspection follows an Unusual Incident at the CCC which occurred on 4/1/26. The incident was reported to the Department on 4/3/26 through a telephone call. Importantly to note, the CCC’s hours of operation are Monday through Friday from 7:30 AM until 4:30 PM.

In regards to the incident, on 4/1/26, at or around 11:40 AM, a staff member from the organization "Grow with Me or Creciendo Juntos" was present at the CCC offering therapy services for a child in care. "Grow with Me or Creciendo Juntos" offers Applied Behavioral Analysis (ABA) therapy for children 0-3 years of age. At a point during the visit, the staff member from "Grow with Me or Creciendo Juntos" went to use the staff bathroom at the CCC. Shortly thereafter, a staff member from the CCC, S2, went to use the same bathroom. S2 reported to colleagues, S3 and S4, that there was a strong marijuana odor present in the bathroom. S3 and S4 then proceeded to walk in the bathroom to confirm the smell of marijuana and also attested of the same odor of S2. Importantly to note, no children were exposed to the smoke and/or odor due to the incident occurring in the staff bathroom.

During today's visit, 4/6/26, the LPA toured the facility and had in-depth conversation with the Facility Representative and (CONT. LIC 809-C, Page 2)

NAME OF LICENSING PROGRAM MANAGER: Maria Mueller
NAME OF LICENSING PROGRAM ANALYST: Matthew Sapien
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 04/06/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/06/2026
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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 - PASO ROBLES HEAD START
FACILITY NUMBER: 401711512
VISIT DATE: 04/06/2026
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two other relevant staff members pertaining to the incident that took place at the CCC on 4/1/26. During today's visit, the Facility Representative informed LPA that the staff member from "Grow with Me or Creciendo Juntos" will no longer be offering therapy services at the CCC, but is unaware of the staff member is still employed by the organization. "Grow with Me or Creciendo Juntos" is aware of the incident regarding their staff member as the Facility Representative of the CCC had an in-depth conversation on 4/3/26.

The Facility Representative 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, Makala Gardner. Facility Representative was provided with a Notice of Site Visit (LIC 9213). The Notice of Site Visit form must be posted for 30 days or a civil penalty of $100 may apply.

NAME OF LICENSING PROGRAM MANAGER: Maria Mueller
NAME OF LICENSING PROGRAM ANALYST: Matthew Sapien
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/06/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/06/2026
LIC809 (FAS) - (06/04)
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