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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426215763
Report Date: 04/19/2024
Date Signed: 04/19/2024 02:40:27 PM

Document Has Been Signed on 04/19/2024 02:40 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
CENTRAL COAST-CHILD, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:LOMPOC VALLEY CHILDREN'S CENTER LAB SCHOOLFACILITY NUMBER:
426215763
ADMINISTRATOR/
DIRECTOR:		M. RAMOS & Y. FRAZIERFACILITY TYPE:
850
ADDRESS:ONE HANCOCK DRIVE, BLDG.2-122TELEPHONE:
(805) 735-3366
CITY:LOMPOCSTATE: CAZIP CODE:
93436
CAPACITY: 26TOTAL ENROLLED CHILDREN: 26CENSUS: 13DATE:
04/19/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:15 PM
MET WITH:Alicia Cardenas TIME VISIT/
INSPECTION COMPLETED:
02:50 PM
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On April 19, 2024 Licensing Program Analyst (LPA) Giovani Gonzalez conducted an unannounced Case Management - Incident inspection at the above-mentioned Child Care Center (CCC). LPA met with Site Supervisor Alicia Cardenas and informed them the purpose of the inspection. At the time of the inspection there were 13 children present and 4 staff present.

On 4/15/2024 the CCC self reported an incident that occurred on 4/10/2024 where a C2 allegedly displayed inappropriate behavior with C1.

LPA conducted interviews with staff that were present when the incident occurred. According to Staff 1 (S1) and Staff 2 (S2) they did not observe C2 display an inappropriate behaviors in the presence of C1. S1 and S2 stated that there was not any moment where C2 and C1 could have been left unsupervised. S1 stated that there is always someone in the bathroom area and that children never go to the restroom by themselves. The Site Supervisor stated that the day of the alleged incident that C2 was only present at the facility for about 55 minutes because they got sent home due to being sick. LPA observed the bathroom area and S1 demonstrated to LPA how they ensure that there is supervision even in the restroom.

Site Supervisor provided statements from the S1 and S2 of what occurred that day as well.

Additional information is needed to conclude the Case Management - Incident. Report was reviewed with Site Supervisor Alicia Cardenas and copy was provided. Notice of site visit was given.
SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Giovani Gonzalez
LICENSING EVALUATOR SIGNATURE: DATE: 04/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/19/2024
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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