561700025-10-16-2024-17-CC-EBAY-DA4VVL-20241016164632

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 561700025
Report Date: 10/16/2024
Date Signed: 10/16/2024 04:46:40 PM

Document Has Been Signed on 10/16/2024 04:46 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
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME:	BETHANY CHRISTIAN SCHOOL		FACILITY NUMBER:	561700025
ADMINISTRATOR/ DIRECTOR:	SARA DEMOLAY		FACILITY TYPE:	850
ADDRESS:	200 WEST BETHANY COURT		TELEPHONE:	(805) 497-7072
CITY:	THOUSAND OAKS	STATE: CA	ZIP CODE:	91360
CAPACITY: 92	TOTAL ENROLLED CHILDREN: 92	CENSUS: 3	DATE:	10/16/2024
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	02:00 PM
MET WITH:	Kerry Ga/vin		TIME VISIT/ INSPECTION COMPLETED:	05:00 PM

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On 10/16/24, at 2:00 PM, Licensing Program Analyst (LPA) Elvin Baddley conducted an unannounced Three Year Required inspection of the abovementioned Child Care Center (CCC). LPA met with Kerry Gavin, Director of the CCC. LPA explained the purpose and nature of the inspection. The facility is located on the grounds of Bethany Christian School. The Preschool operates Monday – Friday 7:30 AM – 5:15 PM. The facility uses four classroom for child care services; Room 101 (3 years of age), Room 102 (Pre Kindergarten age), Room 103 (Pre Kindergarten age) and Room 209 (2.5 -3 years of age, Monday, Wednesday and Friday). Rooms 101, 102 and 103 are located on the first floor of the CCC, while Room 209 is on the second floor of the CCC. All classrooms have ground access. At the time of inspection, LPA observed 3 children on site, along with 2 teachers (cleared and associated) providing care and supervision. It should be noted the bulk of the children enrolled in the CCC were on a field trip outside of the facility during the time of the inspection according to the Director.

The CCC is clean and orderly. LPA observed required licensing forms and documents posted on a bulletin board (enclosed in glass) on the main walkway to the CCC. The CCC has posted schedules of activities affixed to classroom walls. LPA observed the CCC's Sign In/Out forms. The forms contained the arrival and departure times of children in care and well as the signatures of the children's authorized representatives. Each classrooms of the CCC has age appropriate equipment and furnishings available for children in care. LPA also observed waste receptacles throughout the CCC with thigh fitting lids. The CCC has a carbon monoxide detector in the hallway between Room 101 and Room 102 which was tested at 4:01 PM and found to be operable.

The CCC uses a total of three restrooms. All restrooms are in safe and sanitary operating condition. The CCC has a refrigerator in the Director's office which is capable of storing food and beverages for children in care. Lunches and snacks are provided by the parents of children in care. Children also have the ability to receive (purchase) lunches from a school vender. The CCC has available drinking water for children inside and outside of the facility. Children have to ability to bring drink water from home as well. CCCs constructed before 1/1/20, to test their water (used for drinking and food preparation) for lead contamination before 1/1/23, and then every 5 years, after the date of the first test. (CONT. LIC 809-C, Page 2)

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE:	DATE: 10/16/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2024

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: BETHANY CHRISTIAN SCHOOL	FACILITY NUMBER: 561700025
	VISIT DATE: 10/16/2024

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For CCC licenses issued after 7/1/22, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP). LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

Medication at the CCC is stored in a centralized location (Main Office) which is inaccessible to children in care. Sharps and cleaning compounds in each classroom are in locations which are accessible to staff members, but inaccessible to children in care. Each classroom has a Fist Aid Kit.

The CCC outdoor playground areas are enclosed by a combination of chained link and wrought iron fencing. The fence’s entry/exit gates are secured. The surfaces of the outdoor playground areas are varied. LPA observed a metal cabinet which contains CCC's supplies. Cleaning compounds in the metal cabinet are on an elevated shelf which is beyond the reach of children in care. LPA observed age appropriate play equipment in the play areas. The play equipment is free of sharp, loose or pointed objects. The play structures in the outdoor playground areas have adequate cushioning materials to absorb falls and shade created by building overhangs, shade sails and large trees. LPA reminded Director to replace outdoor play equipment and furnishings when such items begin to degrade or are not in good repair. LPA observed no bodies of water at the CCC.

LPA reviewed children, staff and facility records. The children’s records sampled were complete and found to contain emergency contact information and immunization records, among other required licensing documentation and forms. Staff records were reviewed. Staff records sampled were complete and found to contain First Aid/CPR certifications (EMSA approved) and Mandated Reporter Training certification, among other required licensing documentation and forms. LPA notes the last disaster drill at the facility occurred on 9/26/24. There is firearms and ammunition on site as the CCC contracts with an armed security guard vendor.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of “medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication. Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.
(CONT. LIC 809-C, Page 3)

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE:	DATE: 10/16/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2024

LIC809 (FAS) - (06/04)

Page: 2 of 3

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: BETHANY CHRISTIAN SCHOOL	FACILITY NUMBER: 561700025
	VISIT DATE: 10/16/2024

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Facility representative was reminded that all adults 18 and over, including employees and volunteers,
as specified in HSC section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Facility representative Kerry Galvin.

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE:	DATE: 10/16/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2024

LIC809 (FAS) - (06/04)

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