<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197414519
Report Date: 11/18/2020
Date Signed: 11/20/2020 03:31:21 PM

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:NEW YERBA BUENA ELEMENTARY SITE, THEFACILITY NUMBER:
197414519
ADMINISTRATOR:MEGAN TISLERFACILITY TYPE:
840
ADDRESS:6098 REYES ADOBE RD.TELEPHONE:
(818) 735-0112
CITY:AGOURA HILLSSTATE: CAZIP CODE:
91301
CAPACITY:40CENSUS: 6DATE:
11/18/2020
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Megan TislerTIME COMPLETED:
04:30 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 11/18/2020 at 3pm, Licensing Program Analyst (LPA) Michael Avila conducted a tele-video CASE MANAGEMENT inspection via FaceTime (due to the COVID-19 State of Emergency). LPA Avila met with Program Director Megen Tisler regarding the request for increased capacity (request is to increase the school-age program capacity from 40 to 60 children).

The new room is located on the public school campus of New Yerba Buena Elementary School. The new room (identified as F101) was observed equipped with age appropriate furniture. The restroom is located outside the classroom. There is a playyard on the campus. Shade is provide via an awning on the side of the building. Water is available via a water fountain both inside and outside the classrooms.

A Fire Inspection Clearance was conducted by the Los Angeles Fire Department on 10/21/2020.

The facility is licensed effective today, 11/18/2020 for 60 children.

LPA Avila reviewed COVID-19 guidelines/resources with the Program Director who informed LPA that they had previously completed a COVID-19 Technical Assistance tele-video inspection. LPA also reminded Licensee to continue monitoring the CCLD website at www.ccld.ca.gov for updates.

Exit interview was conducted with Program Director Megan Tisler. This report will be sent to via email with a read receipt or confirmation of receipt of email, which will act as the Director's signature.
SUPERVISOR'S NAME: George MingleTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Michael AvilaTELEPHONE: (805) 722-5133
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2020
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 1