406210901-2-6-2026-17-CC-MSAN-DQYRR8-20260204121444

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 406210901
Report Date: 02/04/2026
Date Signed: 02/06/2026 04:26:49 PM

Document Has Been Signed on 02/06/2026 04:26 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, INC		FACILITY NUMBER:	406210901
ADMINISTRATOR/ DIRECTOR:	JOHNA DE BELLIS		FACILITY TYPE:	850
ADDRESS:	533 15TH STREET		TELEPHONE:	(805) 238-5059
CITY:	PASO ROBLES	STATE: CA	ZIP CODE:	93446
CAPACITY: 24	TOTAL ENROLLED CHILDREN: 24	CENSUS: 11	DATE:	02/04/2026
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:40 AM
MET WITH:	Johna De Bellis		TIME VISIT/ INSPECTION COMPLETED:	12:40 PM

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On 2/4/26, at 9:40 AM, Licensing Program Analyst (LPA) Matthew Sapien conducted an annual random inspection of the abovementioned Child Care Center (CCC). LPA met with Johna De Bellis, Director of the CCC, and explained the purpose of the inspection. LPA toured the entirety of the the CCC (interior and exterior). The CCC uses two classrooms at the CCC (one Preschool classroom and one Pre-K classroom), one bathroom, and one outdoor play yard. Importantly to note, children are escorted through the kitchen area to access the outdoor play yard. There is also an office for the Director, along with a staff bathroom, all of which are off limits for children in care.

The CCC operates Monday through Friday from 8:30 AM until 12:00 PM. At the time of the inspection, LPA observed 7 children on the Preschool side and 4 children on the Pre-K side totaling 11 children. In addition to the Director, LPA also observed 2 additional staff (cleared and associated) and one parent volunteer.

The classrooms of the CCC are clean and orderly. The classrooms have age-appropriate equipment and furnishings for children in care. The classrooms contain a number of closets and storage spaces all of which contain items, equipment, and other related objects for children in care. As mentioned prior, the Preschool classroom and Pre-K classroom each utilize the same bathroom, both of which possess adequate numbers of toilets and sinks for children in care. There are 2 sinks and 2 toilets in the bathroom. The bathrooms were found to be clean, orderly, and rid of any hazardous items for children in care.

At the CCC, children bring one snack that is brought from home. Lunch is not had given the operational hours of the program. Filtered water is provided by the CCC via a water dispenser. Children bring reusable water bottles from home and plastic cups are also available for each child in care.

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 the water on site is not used for drinking or food preparation. (CONT. LIC 809-C, Page 2)

NAME OF LICENSING PROGRAM MANAGER: Maria Mueller
NAME OF LICENSING PROGRAM ANALYST: Matthew Sapien
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 02/04/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2026

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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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: 02/04/2026

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LPA observed daily routine schedules, required notices, and other relevant licensing documents posted prominently at the entrance of the CCC. At the CCC, children's sign in and sign out sheets are completed on paper and stored within a binder at the entrance way. LPA found that the CCC completed their most recent disaster drill on 10/16/25. Director informed LPA that the CCC conducts disaster drills every six months.

In the Preschool classroom, a carbon monoxide detector was tested at 10:34 AM and a smoke detector was tested at 10:35 AM and each were found to be operational. In the Pre-K classroom, a carbon monoxide detector was tested at 10:35 AM and a smoke detector was tested at 10:36 AM and each were found to be operational. Cleaning supplies are stored in various locked and elevated spaces in the kitchen area. Sharps are stored in elevated areas, also in the kitchen. No children currently require medication at the CCC. LPA viewed various First Aid Kits in the CCC. The First Aid Kits were observed to contain appropriate supplies.

As mentioned prior, the CCC has access to a large outdoor play yard. The outside playground area is enclosed by metal and wooden fencing throughout. The fence’s entry and exit gates in the yard are secure and furnishings in the area are age appropriate. The play equipment is free of sharp, loose, or pointed objects. The play structures in the outdoor playground areas have adequate cushioning to absorb falls (large sandbox). The surface of the outdoor playground area is varied. The areas are made up of both concrete pavement, rock pebbles, artificial turf, natural grass, and dirt. Shade is provided by various sun sails in the yard. LPA also observed a sizable concrete slab that is used as a bike path and for other various play. LPA also observed a number of sandboxes and water tables throughout the yard. LPA reminded the Director of the safe practices when it comes to water table usage, however, LPA was informed that sand is typically stored in the tables. LPA observed 7 locked sheds in the yard, each of which were locked, and items related to the center. Facility Representative attested to LPA 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's 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 Mandated Reporter Training certificates among other relevant licensing documents. LPA confirmed that there are no bodies of water, firearms, or ammunition that are on site.

LPA discussed the safe sleep regulations with Director and discussed the Child Care Licensing Safe Sleep at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep (CONT. 809-C, Page 3)

NAME OF LICENSING PROGRAM MANAGER: Maria Mueller
NAME OF LICENSING PROGRAM ANALYST: Matthew Sapien
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 02/04/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2026

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: 02/04/2026

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as an additional resource. This facility does not currently care for infants 24 months and under.

This facility does not 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 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 citations were issued.

During the exit interview, the Facility Representative confirmed that there are no Registered Sex Offenders living in the facility when the LPA completed an RSO profile in FAS on 2/4/26.

Facility Representative was provided with Appeal Rights (LIC 9058) and a Notice of Site Visit (LIC 9213). The Notice of Site Visit form must be posted for 30 days or a civil penalty of $100 may apply.

An exit interview was conducted, and the report was reviewed with Facility Representative, Johna De Bellis.

NAME OF LICENSING PROGRAM MANAGER: Maria Mueller
NAME OF LICENSING PROGRAM ANALYST: Matthew Sapien
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 02/04/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2026

LIC809 (FAS) - (06/04)

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