406213912-2-14-2023-17-CC-EBAY-CP2U55-20230214141610

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 406213912
Report Date: 02/14/2023
Date Signed: 02/14/2023 02:17:20 PM

Document Has Been Signed on 02/14/2023 02:17 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:	CENTRAL COAST MONTESSORI		FACILITY NUMBER:	406213912
ADMINISTRATOR:	LAURIE HOLCOMB		FACILITY TYPE:	850
ADDRESS:	3230 MAIN STREET		TELEPHONE:	(805) 772-9317
CITY:	MORRO BAY	STATE: CA	ZIP CODE:	93442
CAPACITY: 24	TOTAL ENROLLED CHILDREN: 24	CENSUS: 23	DATE:	02/14/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:05 PM
MET WITH:	Laurie Holcomb		TIME COMPLETED:	02:45 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 2/14/23, at 12:05 PM, Licensing Program Analyst (LPA) Elvin Baddley conducted an unannounced Required Inspection of the abovementioned Child Care Center (CCC). LPA met with Laurie Holcomb, Director of the CCC and explained the purpose of the inspection. LPA, in the company of Director, toured the interior and exterior of the CCC. The CCC operates from 7:30 AM to 5:30 PM, Monday - Friday. The preschool uses a single [great] room for child care services. LPA observed 23 children on site at the time of the inspection, along with a teacher (cleared and associated) providing care and supervision. LPA observed the CCC to be clean and organized. The CCC has age appropriate toys, equipment and furnishings available for children in care. The classroom has an operable carbon monoxide detector and the restrooms children use are in safe and sanitary operating condition. The CCC has an operable refrigerator which contains foods consumed by children in care. Director informed LPA children bring lunches from home while the CCC supplies individualized snacks. Lunches are inspected to ensure children's lunches contain food from the essential food groups and are void of unhealthy choices. LPA observed a posted menus in the classroom which outlined the future snacks to be provided along with licensing required notices and documents.The CCC has available drinking water for children in the interior and exterior of the CCC. At, or about 12:45 PM, LPA asked the Director if the facility water sources have been tested for lead containment. The Director informed LPA the CCC's water sources have not been tested. LPA informed the Director of the need for the CCC's water sources to be tested for lead containments. Director informed LPA bottled/filter water is provided for children however, build water is used to rinse snacks. LPA observed disinfectants and cleaning solutions on an elevated shelf in the CCC's storage area which is inaccessible to children in care. The Director informed LPA the CCC currently has no medication on site however, when medication is present, the medication is stored in the storage area on an elevated shelf, inaccessible to children in care. LPA notes Sign In/Out form were reviewed and completed appropriately. (CONT. 809-C, Page 2)

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE:	DATE: 02/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2023

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 02/14/2023 02:17 PM - It Cannot Be Edited

Created By: Elvin Baddley On 02/14/2023 at 01:21 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: CENTRAL COAST MONTESSORI	FACILITY NUMBER: 406213912
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/14/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1597.16(a)(1)

Lead Testing

(1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on site interview and record review with Licensee, the Licensee did not comply with the section cited above in that Child Care Center's water sources have not been tested for lead contamination levels which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 02/28/2023
	Plan of Correction
1 2 3 4	Licensee to have Child Care Center's water sources tested for lead contamination levels and Licensee to provide a copy of tested result to CCLD (elvin.baddley@dss.ca.gov or mailed to 6500 Hollister Ave., Suite 200, Goleta, CA 93117) no later than 2/28/23.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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: 02/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2023

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
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: CENTRAL COAST MONTESSORI	FACILITY NUMBER: 406213912
	VISIT DATE: 02/14/2023

NARRATIVE

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The CCC’s outdoor playground area is enclosed by a chain linked fence and contains varied footing. The fence’s entry/exit gate is secured. LPA observed age appropriate toys and play equipment in the play area. The toys and play equipment are in suitable condition and free of sharp, loose or pointed objects. LPA observed the play structures in the playground area has adequate cushioning materials to absorb falls and shade cover is provided by the building overhangs. No bodies of water are observed on site. Waste receptacles with tight fitting covers were observed throughout the center.

A sampling of staff and children records were reviewed. The children’s records were complete and found to contain emergency contact information as well as immunization records. Staff records were reviewed and contained qualifications and Mandated Reporter Training. Director informed LPA no firearms or ammunition is stored on site.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

Facility representative was reminded that all adults 18 and over, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

A Type B deficiency are being cited based on LPA’s observations and record reviews pursuant to Title 22 of the CA Code of Regulations (refer to LIC 809-D). Licensee was provided a copy of their appeal 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 Laurie Holcomb

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE:	DATE: 02/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2023

LIC809 (FAS) - (06/04)

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