<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 401712170
Report Date: 12/10/2024
Date Signed: 12/10/2024 02:27:14 PM

Document Has Been Signed on 12/10/2024 02:27 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:ST. ROSE SCHOOLFACILITY NUMBER:
401712170
ADMINISTRATOR/
DIRECTOR:
CHAMBERLAIN, LORIFACILITY TYPE:
850
ADDRESS:820 CRESTON RD.TELEPHONE:
(805) 238-0304
CITY:PASO ROBLESSTATE: CAZIP CODE:
93446
CAPACITY: 49TOTAL ENROLLED CHILDREN: 49CENSUS: 32DATE:
12/10/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:09 AM
MET WITH:Lori ChamberlainTIME VISIT/
INSPECTION COMPLETED:
12:55 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
On 12/10/24, at 10:09 AM, Licensing Program Analyst (LPA) Matthew Sapien conducted an unannounced Annual Random Inspection of the abovementioned Child Care Center (CCC). LPA met with Lori Chamberlain, Director of the CCC, and explained the nature and purpose of the inspection. The LPA, in the company of the Director, toured the interior and exterior of the CCC. The CCC utilizes two classrooms (classroom 1 which is for children ages 4-5 and classroom 2 which is for children ages 2.8-4), an outdoor play area, and 2 restrooms with contains 4 toilets. The CCC is located on the grounds and campus of St. Rose Catholic Church.

The CCC's hours of operation are 7:30 AM until 4:30 PM Monday through Friday. During the inspection, LPA observed a total of 32 children in care along with 5 additional staff members (all cleared and associated).

The two classrooms of the CCC are clean and orderly. The classrooms have age-appropriate toys, books, and other furnishings for children in care. Classroom 1 has an operational refrigerator which contains food items for children in care. The CCC provides morning and afternoon snacks for children in care, while lunches are brought from households. There is available drinking water for children at the CCC via reverse osmosis faucets. Children are provided with water bottles from the CCC so that the correct amounts of water are being monitored and consumed.

CCCs constructed before 1/1/20, are supposed 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). LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP. (CONT. LIC 802-C)
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Matthew Sapien
LICENSING EVALUATOR SIGNATURE: DATE: 12/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/10/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3
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: ST. ROSE SCHOOL
FACILITY NUMBER: 401712170
VISIT DATE: 12/10/2024
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
26
27
28
29
30
31
32
LPA observed snack menus and required notices and other relevant documents posted prominently throughout each of the two classrooms. LPA also reviewed the children's sign in/sign out forms and found the arrival times of children, along with the departure times. The signatures of authorized representatives were also present.


LPA observed carbon monoxide detectors in each of the classrooms at the CCC, where they were tested at 10:24 AM in classroom 2 and 10:36 AM in classroom 1. Each detector were found to be operational. Cleaning compounds, sharps, and medication are stored in elevated cabinets in classroom 1. The CCC's kitchen area, located in classroom 1, also has additional sharps, cleaning compounds, and a First Aid kit that contains gloves, band-aids, and other appropriate supplies. Similar to classroom 1, classroom 2 has cleaning compounds and sharps stored in elevated cabinets. No medication is stored in classroom 2. Each of the classrooms possess First Aid Kits. Two restrooms, which possess 4 toilets, are utilized for the CCC. One restroom is connected to classroom 1, and the other is an exterior bathroom located nearby.

The outdoor playground area is enclosed by wooden and metal fencing throughout. The fence’s entry/exit gates are secure and furnishings in the area are age appropriate. The play structure in the outdoor play area has adequate cushioning material (wood chips) to absorb falls. The footing of the exterior is varied (natural grass, sand, and dirt). Shade is provided by two shade covers, a metal pergola structure, and by building overhangs throughout. Director attested that children are always supervised while outside and that the outdoor area is inspected prior to letting children outside.

A sampling of staff and children records were reviewed. The children’s records were complete and were found to contain emergency contact information as well admission agreements, among other relevant licensing documents and forms. Staff records were reviewed and contained current pediatric CPR and First Aid certifications (EMSA approved) and Mandated Reporter Training certificates. Facility records show the last fire drill on site occurred on 11/19/24. Director informed LPA that drills are conducted on a monthly basis. LPAs confirmed that there are no bodies of water, firearms, or ammunition that are stored on site.

This facility does not currently provide Incidental Medical Services – IMS. LPAs reviewed storage of medication supplies. LPAs also reviewed children’s, personnel, and administrative records in relation to IMS (CONT. 809-C, Page 3)
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Matthew Sapien
LICENSING EVALUATOR SIGNATURE:

DATE: 12/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/10/2024
LIC809 (FAS) - (06/04)
Page: 2 of 3
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: ST. ROSE SCHOOL
FACILITY NUMBER: 401712170
VISIT DATE: 12/10/2024
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
26
27
28
29
30
31
32
services. 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 HSC 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.


Facility representative 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.

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

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, Lori Chamberlain.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Matthew Sapien
LICENSING EVALUATOR SIGNATURE:

DATE: 12/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/10/2024
LIC809 (FAS) - (06/04)
Page: 3 of 3