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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 406210272
Report Date: 05/17/2022
Date Signed: 05/17/2022 11:14:13 AM

Document Has Been Signed on 05/17/2022 11:14 AM - 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:NIPOMO RECREATION - LITTLE BITS PRESCHOOLFACILITY NUMBER:
406210272
ADMINISTRATOR:MIRANDA AGUILARFACILITY TYPE:
850
ADDRESS:255 POMEROYTELEPHONE:
(805) 929-4175
CITY:NIPOMOSTATE: CAZIP CODE:
93444
CAPACITY: 35TOTAL ENROLLED CHILDREN: 35CENSUS: 27DATE:
05/17/2022
TYPE OF VISIT:CollateralUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Miranda AguilarTIME COMPLETED:
10:20 AM
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On 5/17/2022 at 9:00 AM Licensing Program Analyst (LPA) Gigi Reyes conducted a collateral inspection and met with Program Director Ms. Miranda Aguilar. Prior to inspection LPA asked pre screening questions related to COVDI-19, Director's responses indicate there are no COVID 19 exposure on site. LPA discussed the purpose of the inspection to interview Staff # 7. There were 27 children and 5 staff present during the inspection.

There were no deficiencies cited. A technical Advisory - Assistance was issued.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Program Director, Ms. Miranda Aguilar.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE: DATE: 05/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/17/2022
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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