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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 561700408
Report Date: 09/16/2019
Date Signed: 09/16/2019 11:33:10 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:UNITED METHODIST CHILD DEVELOPMENT CENTERFACILITY NUMBER:
561700408
ADMINISTRATOR:KAREN LUNDBERGFACILITY TYPE:
850
ADDRESS:291 ANACAPA DRIVETELEPHONE:
(805) 482-2537
CITY:CAMARILLOSTATE: CAZIP CODE:
93010
CAPACITY:106CENSUS: 54DATE:
09/16/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Karen LundbergTIME COMPLETED:
11:45 AM
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Licensing Program Analysts (LPAs), Laura Villanueva and Betzayra Cervantes made an unannounced inspection in order to conduct an Annual/random review and met with the Director, Karen Lundberg. The purpose of the visit was discussed and a tour of the inside and outside of the facility was conducted. There are 5 classrooms with 10 Teachers. The hours are from Monday through Friday from 9:00am to 12:00pm. There is a stay and play from 12:00pm to 1:30pm. and early drop off 8:30am to 9:00am. All were found to be clean, organized with age appropriate toys, games books, cubbies, tables and chairs. The bathrooms were found clean and free of toxins. There is a functioning carbon monoxide detector in each classroom that meets statutory requirements.
The outdoor play areas are completely fenced and LPA observed age appropriate toys, games, shade areas, and sand box area. Drinking water is available inside and outside. Snack is provided by parents on a rotation schedule. Menu is posted.

Teacher files reviewed and were found complete with State required forms. Teacher is current with CPR and First Aid which expires 11/2/20. The next fire drill will be conducted on 9/26/19.
Sign in and sign out was verified and matched census. Children's files reviewed. Center staff are current with immunization requirements per SB 792. Teachers are current with Mandated Reporter Training.

The center is currently providing Incidental Medical Services. Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm
SUPERVISOR'S NAME: George MingleTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Laura VillanuevaTELEPHONE: (805) 722-5138
LICENSING EVALUATOR SIGNATURE:

DATE: 09/16/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 2
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: UNITED METHODIST CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 561700408
VISIT DATE: 09/16/2019
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Director receives Quarterly Updates. Director has copies of Lead Poisoning Pamphlet that was given to parents.

In areas evaluated, no deficiencies were cited. Notice of site visit posted in presence of LPAs.


THE NOTICE OF SITE VISIT WAS POSTED AS REQUIRED BY H&S CODE SEC. 1596.817. THE NOTICE OF SITE VISIT MUST REMAIN POSTED FOR 30 DAYS OR A CIVIL PENALTY OF $100.00 WILL APPLY.
SUPERVISOR'S NAME: George MingleTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Laura VillanuevaTELEPHONE: (805) 722-5138
LICENSING EVALUATOR SIGNATURE:

DATE: 09/16/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2019
LIC809 (FAS) - (06/04)
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