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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426213750
Report Date: 08/27/2019
Date Signed: 08/27/2019 03:31:49 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:LA PURISIMA CONCEPCION LITTLE SAINTS PRESCHOOLFACILITY NUMBER:
426213750
ADMINISTRATOR:TERESE MUNOZ-HILLFACILITY TYPE:
850
ADDRESS:219 W. OLIVE AVENUETELEPHONE:
(805) 736-6210
CITY:LOMPOCSTATE: CAZIP CODE:
93436
CAPACITY:87CENSUS: 72DATE:
08/27/2019
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:40 AM
MET WITH:Terese Munoz-HillTIME COMPLETED:
12:35 PM
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A case management inspection was conducted by Licensing Program Analysts (LPAs) S. Mendoza-Ceja and C. Patterson who met with Director Terese Munoz-Hill regarding an unusual incident that occurred on August 21, 2019 was reported to the Department as required.

On August 21, 2019, there was an incident when child #1 was acting out and threw a child sized chair toward the carpet area. The chair hit child #2. Child #2 did sustain an injury and was provided first aid, no medical treatment was required. Parents of child #1 and child #2 were notified of the incident. There were two teachers and an aide supervising up to 21 children, in addition to child's #1's personal assistant. LPAs reviewed child #1 and child #2's files.

The center's plan is to continue to provide care and integrate behavioral tools to meet the needs of all the children in care.

No deficiencies cited.
The Notice of Site Visit (LIC 9213) was posted in LPA's presence.

FAILURE TO POST THE NOTICE OF SITE VISIT FOR 30 DAYS MAY RESULT IN A $100.00 CIVIL PENALTY.
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Sylvia Mendoza-CejaTELEPHONE: (805) 722-5132
LICENSING EVALUATOR SIGNATURE:

DATE: 08/27/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2019
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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