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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 406206384
Report Date: 01/29/2026
Date Signed: 01/29/2026 02:38:15 PM

Document Has Been Signed on 01/29/2026 02:38 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 - STEP BY STEP EARLY HEAD STARTFACILITY NUMBER:
406206384
ADMINISTRATOR/
DIRECTOR:		A. RAMIREZ-BARRONFACILITY TYPE:
830
ADDRESS:1055 MESA VIEW DRIVETELEPHONE:
(805) 474-3750
CITY:ARROYO GRANDESTATE: CAZIP CODE:
93420
CAPACITY: 16TOTAL ENROLLED CHILDREN: 16CENSUS: 11DATE:
01/29/2026
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:45 PM
MET WITH:Ruby AlcantarTIME VISIT/
INSPECTION COMPLETED:
02:55 PM
NARRATIVE
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On January 29, 2026, at 1:45pm Licensing Program Analyst (LPA) Elizabeth George conducted an unannounced Case Management Inspection in regards to the Unusual Incident reported on 1/28/26. LPA met with Site Supervisor Ruby Alcantar and discussed the purpose of the inspection which was to follow up on an incident reported to the Department as required. LPA in the company of the site supervisor toured the facility. During the inspection, LPA observed 6 staff providing care to 11 children.

On January 28th at approximately 10:20am, children were outside playing when child 1 watched another child squat while standing on the bench and jump down while placing hands out to catch themselves. When child 1 attempted to copy the action, child 1 did not place their hands out in front of them to catch themselves and hit their forehead and nose on the concrete. One of three staff were within ten feet and immediately picked the child up to comfort and apply first aid. Child sustained a bump on the forehead and a scratch on the nose. Child's mom was called right away and decided the child would stay at the center. The child was picked up at normal time and returned to center the following day. Site supervisor stated during outside play time a rug/mat will be placed in front of the bench to cushion any falls in the future. During the inspection LPA recommended a larger mat to be placed in front of the bench to allow ample coverage, in which site supervisor placed a larger rug in the area.

Based on the information gathered during the inspection, LPA determined that the staff took appropriate action to meet the needs of child 1 and other children in care.

No deficiencies were cited as a result of the incident. Exit interview was conducted, a notice of site visit was given and report was reviewed with the Site Supervisor, Ruby Alcantar.
NAME OF LICENSING PROGRAM MANAGER: Ana Tolentino
NAME OF LICENSING PROGRAM ANALYST: Elizabeth George
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 01/29/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/29/2026
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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