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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 406210272
Report Date: 08/29/2024
Date Signed: 08/29/2024 04:13:30 PM

Document Has Been Signed on 08/29/2024 04:13 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:NIPOMO RECREATION - LITTLE BITS PRESCHOOLFACILITY NUMBER:
406210272
ADMINISTRATOR/
DIRECTOR:		MIRANDA AGUILARFACILITY TYPE:
850
ADDRESS:255 POMEROYTELEPHONE:
(805) 929-4175
CITY:NIPOMOSTATE: CAZIP CODE:
93444
CAPACITY: 35TOTAL ENROLLED CHILDREN: 35CENSUS: 22DATE:
08/29/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:40 PM
MET WITH:Miranda AguilarTIME VISIT/
INSPECTION COMPLETED:
04:30 PM
NARRATIVE
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On 8/29/24, at 2:40 PM, Licensing Program Analysts (LPAs) Elvin Baddley and Matthew Sapien made a unannounced Case Management Inspection of the abovementioned Child Care Center (CCC) to address a violation related to Reporting Requirements. LPAs met with Miranda Aguilar, Administrator of the CCC and explained the nature and purpose of the inspection. LPAs note 22 children are on site at the time of the inspection, along with 4 teachers providing care and supervision.

On 8/9/24, a teacher at the CCC (S1) struck a children in care (C1) about the facial area with an open hand, after C1 yelled at S1 and proceeded to spit on the face and clothing of S1. The incident was witnessed by the acting Site Supervisor (S2). Following the incident, the parents of C1 were contacted and asked to pick C1 from the CCC as C1 was being a disturbance to the CCC's programming. Accordingly, a parent of C1 (P1) arrived at the CCC and removed C1 from care. S2 did not notify P1, nor the other parent of C1 (P2) of the child being struck in care by a teacher. S2 failed to notify CCLD or the local Social Service Department of the incident involving C1 being struck by a teacher of the facility. Moreover, S2 did not notice the CCC's Administration of the abovementioned incident. The CCC's Administrator did notified CCLD and well as the local Social Service Department upon being appraised of the incident by C1's parent, P2 on 8/13/24.

Although the CCC's Administrator made the appropriate notification when appraised of the incident of 8/9/24, Site Supervisor S2 was not responsive to Reporting Requirement as mandated by regulations, pursuant to CCR 101212, despite witnessing a child in care being struck by a staff member.

A Type B Deficiency is being cited based on LPAs' observation/interviews/record reviews pursuant to Title 22 of the CA Code of Regulations and CCR 101212 (f) (refer to LIC 809-D). Licensee 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 Miranda Aguilar.
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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Document Has Been Signed on 08/29/2024 04:13 PM - It Cannot Be Edited


Created By: Elvin Baddley On 08/29/2024 at 03:38 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: NIPOMO RECREATION - LITTLE BITS PRESCHOOL
FACILITY NUMBER: 406210272

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/29/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/12/2024
Section Cited
CCR
101212(f)

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Upon the occurrence, during the operation of the child care center of any of the events specified... report shall be made to the Department...above shall also be reported to the child's authorized representative. This requirement was not met as evidenced by the following: S2
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Licensee to provide CCLD an narrative outlining steps to ensure the CCC is adhering to Reporting Requirements. The aforementioned to be submitted to CCLD (elvin.baddley@dss.ca.gov) by the close (5:00 PM) on 9/12/24.
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did not notify a parent removing C1 from care on 8/9/24, C1 was struck by a teacher in care earlier in the day of 8/9/24, despite S2 witnessing the incident. This poses a potential risk to health, safety or personal rights of persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Maria Mueller
LICENSING EVALUATOR NAME:Elvin Baddley
LICENSING EVALUATOR SIGNATURE:
DATE: 08/29/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/29/2024


LIC809 (FAS) - (06/04)
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