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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 421710981
Report Date: 06/09/2022
Date Signed: 06/09/2022 02:41:47 PM

Document Has Been Signed on 06/09/2022 02:41 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:SANTA YNEZ BRANCH - SANTA YNEZ ELEMENTARYFACILITY NUMBER:
421710981
ADMINISTRATOR:JOHN CROWELLFACILITY TYPE:
840
ADDRESS:3325 PINE STREET, BLDG #27TELEPHONE:
(805) 686-2037
CITY:SANTA YNEZSTATE: CAZIP CODE:
93460
CAPACITY: 30TOTAL ENROLLED CHILDREN: 30CENSUS: 6DATE:
06/09/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Kristine ParraTIME COMPLETED:
03:00 PM
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On 6/9/22, at 1:15 PM, Licensing Program Analyst (LPA) Elvin Baddley conducted an unannounced One Year Required Inspection of the abovementioned Child Care Center (CCC). LPA met with Kristine Parra, Administrator of the CCC and explained purpose of the inspection.

LPA, in the company of Administrator toured the interior and exterior of the CCC. The CCC is a School Age program in a single modular classroom on the grounds of Santa Ynez Elementary school. The CCC operated from 12:30 PM - 6:00 PM, Monday- Friday. At the time of the inspection, the CCC has 6 children in care along with two Assistants (cleared and associated) .

The classroom of the CCC is clean and organized. LPA observed required notices posted predominately on the walls near the classroom's entry/exit. The classroom has age appropriate furnishings and play equipment available for children in care. The CCC has an operable carbon monoxide detector, which was tested at 2:14 PM. Disinfectants, cleaning supplies, medication and sharps are secured in cabinets in the CCC's classroom. All noted items enclosed in cabinets are inaccessible to children in care.

The CCC provides snacks to children and water is available for children both inside and outside of the classroom. Snack items are stored in an operable refrigerator in the classroom. LPA observed a facility menu nears the CCC's refrigerator. The Sign In/Out forms for the CCC were observed near the entry of the classroom and inspected upon arrival. Waste receptacles in the CCC are observed to have tight fitting covers. The restrooms used by children in care, two in total, are clean and free of toxins. Children are escorted to and from the restrooms by the CCC's staff members during the day.

The CCC's outdoor playground areas are enclosed by chain linked fencing. LPA observed age appropriate equipment in the playground areas. Similar to the CCC's restroom, children in care are escorted to the outdoor play area. The CCC use a large grass area along with a Ga Ga Ball court during outdoor activities.
(CONT. 809-C)
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE: DATE: 06/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/09/2022
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: SANTA YNEZ BRANCH - SANTA YNEZ ELEMENTARY
FACILITY NUMBER: 421710981
VISIT DATE: 06/09/2022
NARRATIVE
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SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE:

DATE: 06/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2022
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: SANTA YNEZ BRANCH - SANTA YNEZ ELEMENTARY
FACILITY NUMBER: 421710981
VISIT DATE: 06/09/2022
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The play structure at the elementary school, which the CCC sometimes uses, is not in utilized at this time as the footing is in disrepair. The elementary school is in the process of repairing the aforementioned and the date of completion is currently unknown. LPA observed no bodies of water on site.

Staff and children's records were reviewed. The children’s records were complete and found to contain emergency contact information. Staff records were reviewed and found to be current CPR/First Aid certifications as well as Mandated Reporter training certifications. LPA reminded Administrator to ensure training certifications are kept current and renewed prior to expiration. Administrator inform LPA no firearm or ammunition are stored on the site.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing 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



Administrator was reminded that all adults 18 and over working in the CCC, 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.

A Notice of Site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Administrator Kristine Parra.

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

DATE: 06/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2022
LIC809 (FAS) - (06/04)
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