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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 406216459
Report Date: 05/10/2023
Date Signed: 05/10/2023 02:39:17 PM

Document Has Been Signed on 05/10/2023 02:39 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:AGAPE PRESCHOOLFACILITY NUMBER:
406216459
ADMINISTRATOR:DAWNNA PFARRFACILITY TYPE:
850
ADDRESS:950 LAUREATE LN.TELEPHONE:
(805) 541-0777
CITY:SAN LUIS OBISPOSTATE: CAZIP CODE:
93405
CAPACITY: 30TOTAL ENROLLED CHILDREN: 30CENSUS: 0DATE:
05/10/2023
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Dawnna PfarrTIME COMPLETED:
02:45 PM
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On 5/10/23, at 10:30 AM, Licensing Program Analyst (LPA) Elvin Baddley conducted an announced Prelicense Inspection of the abovementioned Child Care Center (CCC). LPA met with Dawnne Pfarr, Administrator of the CCC and explained the nature/purpose of the inspection. LPA in the company of the Administrator, toured and took necessary measurements of the interior and exterior of the CCC. LPA notes no children were on site during the inspection.

The CCC is on the grounds of Agape Christian Fellowship Church. The CCC consist of four classroom, a multi purpose room and an outdoor activity area. The intended hours of operation for the CCC are 7:00 AM- 6:00 PM, Monday through Friday. The CCC is expected to begin operations in August of 2023 and serve children 2 years to 5 years of age

The CCC's four classroom have divides which will allow four classroom to become two large classroom. Currently, the rooms are designated to be the following, Classroom #1: 2 years to 3 years of age, Classroom #2:3 years to 4 years of age; Classroom 3: 4 years to 5 years of age; Classroom 4 2 years to 3 years of age. LPA observed age appropriate cubbies, furniture, toys and games in each classroom. LPA also observed required licensing documents posted near the entry door in the CCC's Multipurpose Room.

The CCC has a kitchen which can be secured. The kitchen is inaccessible to children. The CCC's carbon monoxide detector is intergraded in the CCC's fire system, thus the detector was not tested. The CCC will be providing filtered drinking water for children in care in care both inside of the CCC and outside in the play area. The CCC water sources have been tested for lead containments. Lunches are provided to the children by their caregiver as opposed to the CCC. The CCC furnishes individual snacks to the children. LPA observed a menu posted near the entry of the CCC. The restroom used by children in care is observed to be in safe and sanity condition.

The outdoor activity area has shade provided by trees and the building's overhang. The area is completely

(CONT. 809-C, Page 2)

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE: DATE: 05/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/10/2023
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 3
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: AGAPE PRESCHOOL
FACILITY NUMBER: 406216459
VISIT DATE: 05/10/2023
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fenced by chained linking and the footing in the area is varied. The area has a large mound with slides as well as shed containing CCC supplies. LPA notes the shed is secured. The entry/exits gates in the area are secured. LPA observed no bodies of water on site. Play structures in the area are free of hazards and sharp points. The fall zones around the play structure have appropriate cushioning. LPA reminded Administrator to ensure all play structures in the outdoor area are age appropriate.

This facility provides Incidental Medical Services – IMS. LPA discussed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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

LPA discussed the requirement for care providers/employees, including volunteers to obtain immunization against Influenza, Pertussis, Measles, including verification of TB. Administrator immunization record is on file.



Applicant, was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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 licensed 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

LPA reviewed with applicant the LIC 311A, Forms/Records To Keep In Child Care Center, children’s forms/records, facility forms/records, and information to be posted. Children's record keeping requirements were reviewed.



Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.
To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe

(CONT. 809.C, Page 3)

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE:

DATE: 05/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2023
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: AGAPE PRESCHOOL
FACILITY NUMBER: 406216459
VISIT DATE: 05/10/2023
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and select the Child Care option to receive email communication.

The facility was inspected by San Luis Obispo (SLO) Fire Department and Fire Clearance was granted on for 30 children.

Based on indoor and outdoor space, toilets and sinks, this facility meets Title 22, Division 12 requirements for a CCC with a capacity of 30 children. License effective today, 5/10/23

Exit interview conducted and report was reviewed with the applicant, Dawnne Pfarr


SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE:

DATE: 05/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2023
LIC809 (FAS) - (06/04)
Page: 3 of 3