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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 406215833
Report Date: 08/14/2019
Date Signed: 08/14/2019 10:59:05 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:VILLAGE PRESCHOOLFACILITY NUMBER:
406215833
ADMINISTRATOR:KAMBER DOUCHETTEFACILITY TYPE:
850
ADDRESS:205 SHORT STREETTELEPHONE:
(805) 704-1302
CITY:ARROYO GRANDESTATE: CAZIP CODE:
93420
CAPACITY:30CENSUS: 0DATE:
08/14/2019
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:20 AM
MET WITH:Kamber DoucetteTIME COMPLETED:
11:00 AM
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This is a change of location, prior facility number was 406213969.

Licensing Program Analysts (LPAs) Gigi Reyes and Christian Patterson conducted an announced Pre Licensing inspection and met with Licensee/Director, Ms. Kamber Doucette. The Center was toured and measured inside and outside. The Center meets the capacity requirement of 30 children. The Center is composed of 5 indoor activity rooms. The 5th room located in the backyard was built separate from the main building. There are 2 toilets and 3 sinks and one staff bathroom. LPAs observed age appropriate toys, equipment and furniture in the indoor areas. There is a cubby for each child to place each child's belongings. Cot/Napping equipment were also observed. The back yard is appropriately fenced. There are age appropriate play structure and equipment. The playground is covered with grass and partly dirt. Licensee stated that a gardener is scheduled to trim the growing bushes in the corner of the play yard.

Fire clearance was granted for capacity of 30 on 8/7/2019. There is a functioning carbon monoxide in the main day care building. CPR and First Aid expires on 10/04/2020. The day care will operate Monday to Friday from 7:00 AM to 5:30 PM.

License is pending approval for the carbon monoxide detector for the back room separated from the main building and photo of the groomed backyard.

LPAs observed Licensee/Director posted the Notice of Site Visit.

SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi ReyesTELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:

DATE: 08/14/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/14/2019
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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