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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426211729
Report Date: 12/07/2023
Date Signed: 12/07/2023 04:36:08 PM


Document Has Been Signed on 12/07/2023 04:36 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:ISLA VISTA CHILDREN'S CENTERFACILITY NUMBER:
426211729
ADMINISTRATOR:SERINEH VARTANIFACILITY TYPE:
850
ADDRESS:701 H WEST CAMPUS POINTE LN.TELEPHONE:
(805) 968-0488
CITY:GOLETASTATE: CAZIP CODE:
93117
CAPACITY:30CENSUS: 4DATE:
12/07/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
04:05 PM
MET WITH:Serineh Vartani TIME COMPLETED:
04:45 PM
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On December 7, 2023 Licensing Program Analyst Giovani Gonzalez conducted an unannounced Case Management - Incident inspection at the above-mentioned Child Care Center (CCC) to follow up on an Unusual Incident Report filed on 10/3/2023. LPA met with Director Serineh Vartani and informed them the purpose of the inspection. At the time of the inspection there were 4 children present.

On 10/3/2023 the CCC reported that two children were playing inappropriately with each other. An interview with Director revealed that they followed the proper protocol. Children still attend the CCC and are in separate classrooms. The incident was reported CWS and at this time it is still under investigation.

No deficiencies were cited as a result of the incident. Report was reviewed with Director Serineh Vartani and notice of site visit was given.
SUPERVISOR'S NAME: Ana TolentinoTELEPHONE: (805) 562-0347
LICENSING EVALUATOR NAME: Giovani GonzalezTELEPHONE: (805) 722-5132
LICENSING EVALUATOR SIGNATURE:
DATE: 12/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/07/2023
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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