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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 401711736
Report Date: 06/18/2021
Date Signed: 06/18/2021 11:42:09 AM

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:OCEANVIEW ELEMENTARY SCHOOLFACILITY NUMBER:
401711736
ADMINISTRATOR:CARRIE VAN BEVERENFACILITY TYPE:
840
ADDRESS:1208 LINDA DRIVETELEPHONE:
(805) 473-5476
CITY:ARROYO GRANDESTATE: CAZIP CODE:
93420
CAPACITY:84CENSUS: 20DATE:
06/18/2021
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Carrie Van BeverenTIME COMPLETED:
09:45 AM
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On 6/18/21, Licensing Program Analyst (LPA) Elvin Baddley conducted an unannounced Case Management Inspection of the abovementioned Child Care Center (CCC) to assess a request for the use of another classroom on the grounds of Oceanview Elementary School given the need for social distancing and additional spacing. LPA met with Administrator Carrie Van Beveren to initiate the inspection. LPA notes 20 children were at the CCC, however none were present in the classroom to be inspected.

Upon explaining the purpose and nature of the inspection, LPA toured and interior and exterior of the classroom (Room F). The classroom is a module building with ample ventilation to afford for child care services. LPA observed age appropriate furnishing, toys and equipment in the classroom. LPA observed a carbon monoxide detector in the classroom which was tested at 9:20 AM and found to be operable. LPA also observed a bulletin board near the entry/exit of the classroom which displayed required licensing forms and documents. LPA observed medication, sharps and cleaning supplies in a secure cabinet in the room.

Administrator informed LPA children using the classroom will also have access to the outdoor play areas and restrooms currently being used by the CCC.

The classroom is consider a suitable area and is approved for use as part of the CCC's child care effective 6/18/21.
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Elvin BaddleyTELEPHONE: (805) 635-4697
LICENSING EVALUATOR SIGNATURE:

DATE: 06/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2021
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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