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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 406210901
Report Date: 01/13/2025
Date Signed: 01/13/2025 12:32:48 PM

Document Has Been Signed on 01/13/2025 12:32 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:PASO ROBLES CO-OPERATIVE PRESCHOOL, INCFACILITY NUMBER:
406210901
ADMINISTRATOR/
DIRECTOR:		JOHNA DE BELLISFACILITY TYPE:
850
ADDRESS:533 15TH STREETTELEPHONE:
(805) 238-5059
CITY:PASO ROBLESSTATE: CAZIP CODE:
93446
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 12DATE:
01/13/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:20 AM
MET WITH:Johna De BellisTIME VISIT/
INSPECTION COMPLETED:
12:45 PM
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On 1/13/25, at 10:20 AM, Licensing Program Analyst (LPA) Matthew Sapien conducted an unannounced Annual Random Inspection of the abovementioned Child Care Center (CCC). LPA met with Johna De Bellis, 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 (a Pre-K classroom and an age 2-4 classroom), one bathroom, and outdoor play area. The CCC also houses a staff office, staff bathroom, and a kitchen that is inaccessible for children in care. Importantly to note, children only pass through the CCC's kitchen to access the outdoor play area.

The CCC's hours of operation are 8:15 AM until 12:15 PM Monday through Friday. During the inspection, the LPA observed 12 children in care, along with two staff assistants and one parent volunteer (cleared and associated).

The indoor areas that children utilize are clean and orderly. Each of the classrooms have age-appropriate toys, books, and other furnishings for children in care. The CCC does not provide snacks for children in care due to operational hours. Director informed LPA that snacks are brought from home and that lunch is eaten at home. There is available drinking water for children at the CCC via filtered water jugs. Children bring reusable water bottles from home so that the proper water amounts are being monitored and consumed. The CCC also provides water cups for children.

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). Director informed LPA that their water isn't tested for lead contamination due to the CCC providing bottled and filtered water on a daily basis.

LPA reviewed the children's sign in and sign out forms and found the arrival (CONT. LIC 802-C)

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Matthew Sapien
LICENSING EVALUATOR SIGNATURE: DATE: 12/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/23/2024
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 4
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: PASO ROBLES CO-OPERATIVE PRESCHOOL, INC
FACILITY NUMBER: 406210901
VISIT DATE: 01/13/2025
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SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Matthew Sapien
LICENSING EVALUATOR SIGNATURE:

DATE: 12/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/23/2024
LIC809 (FAS) - (06/04)
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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: PASO ROBLES CO-OPERATIVE PRESCHOOL, INC
FACILITY NUMBER: 406210901
VISIT DATE: 01/13/2025
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times of children, along with the departure times at the entryway of the CCC. The signatures of authorized representatives were also present.

LPA observed a number of carbon monoxide and smoke detectors throughout the CCC. A carbon monoxide detector within the 2-4 classroom was tested at 10:35 AM, while a smoke detector was tested at 10:36 AM. Both detectors were found to be operational. Cleaning compounds were observed in each of the classrooms in elevated areas making them inaccessible to children in care. Additional cleaning compounds were observed in the kitchen area beneath the sink in a locked cabinet. Sharps were also observed in the kitchen in an elevated area. Medication was observed in the staff bathroom, which is an area that's off limits for children in care. Four First Aid kits were observed in different areas throughout the CCC.

As mentioned prior, the CCC utilizes 1 bathroom, which is in the Pre K classroom. There are two toilets within the bathroom and it was found to be clean, orderly, and rid of any hazardous items for children in care.

The outdoor play 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 structures in the outdoor play area have adequate cushioning materials to absorb falls. The footing of the exterior is varied (natural grass, pebbled rock, artificial turf, and concrete pavement). In the outdoor area, shade is provided via building overhangs, umbrellas, and various sun shades. In the outdoor play area, LPA observed 6 large sheds. LPA solely observed childcare equipment stored in these compartments. LPA also observed a large concrete slab in the outdoor play area that is utilized primarily for bike riding. 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 11/5/24 and 11/6/24. The drills occurred on consecutive days to account for all groups of children that attend the CCC. Director attested that disaster drills are conducted around three times per year. LPA confirmed that there are no bodies of water, firearms, or ammunition that are stored on site.

(CONT. 809-C, Page 3).
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Matthew Sapien
LICENSING EVALUATOR SIGNATURE:

DATE: 01/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/13/2025
LIC809 (FAS) - (06/04)
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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: PASO ROBLES CO-OPERATIVE PRESCHOOL, INC
FACILITY NUMBER: 406210901
VISIT DATE: 01/13/2025
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This facility does currently provide Incidental Medical Services – IMS. 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, Johna De Bellis.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Matthew Sapien
LICENSING EVALUATOR SIGNATURE:

DATE: 01/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/13/2025
LIC809 (FAS) - (06/04)
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