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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 406210272
Report Date: 09/17/2024
Date Signed: 09/17/2024 04:11:37 PM

Document Has Been Signed on 09/17/2024 04:11 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: 20DATE:
09/17/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:16 PM
MET WITH:Amber VIllamayorTIME VISIT/
INSPECTION COMPLETED:
04:30 PM
NARRATIVE
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On 9/17/2024 at 2:16 PM, Licensing Program Analyst (LPA) Gigi Reyes conducted an unannounced Case Management Inspection at the above Child Care Center (CCC). LPA met with Site Supervisor, Amber Villamayor and discussed the nature of the inspection.
There were 20 children who were in the nap room under the care of 5 staff members.

On September 13, 2024, during outdoor playtime on or about 3:40 PM, The Program Director, Miranda Aguilar who was coming from the parking lot observed Child # 1 outside the fenced play yard of the CCC. C1 had exited designated play area and was on the ground of Nipomo Regional Park.

LPA's review and interview revealed that the incident was not reported to Community Care Licensing (CCL) within 24 hours of its occurrence as required by the regulation.

During today's inspection deficiency was cited and report was reviewed with Site Supervisor, Amber Villamayor.

Notice of Site Visit was issued and must be posted for 30 days.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE: DATE: 09/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/17/2024
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 09/17/2024 04:11 PM - It Cannot Be Edited


Created By: Gigi Reyes On 09/17/2024 at 02:54 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: 09/17/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/27/2024
Section Cited
CCR
101212(d)(1)(C)

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(d) Upon the occurrence, during the operation of the childcare center of any of the events specified in (d)(1) below.(1) Events reported shall include the following: (C) Any unusual incident or child absence that threatens the physical or emotional health or safety of any child.
This requirment is not met as evidenced by:
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The Site Supervisor and Director agreed to submit a written plan of correction outlining the measures on to how ensure that any reportable incident will be reported to the department within 24 hours of its occurrence. POC shall be submitted on or before than 9/27/2024.
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The Child Care Center failed to report the incident of a child that jumped over the play yard fence outside the designated fenced paly yard. This poses a potential risk to health and safety of children 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:Gigi Reyes
LICENSING EVALUATOR SIGNATURE:
DATE: 09/17/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/17/2024


LIC809 (FAS) - (06/04)
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