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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 561700773
Report Date: 01/22/2020
Date Signed: 01/22/2020 01:57:24 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:GROWING PLACE PRESCHOOL, THEFACILITY NUMBER:
561700773
ADMINISTRATOR:KAREN D. JAMESFACILITY TYPE:
850
ADDRESS:1049 WESTLAKE BLVDTELEPHONE:
(805) 497-7064
CITY:WESTLAKE VILLAGESTATE: CAZIP CODE:
91361
CAPACITY:68CENSUS: 18DATE:
01/22/2020
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Karen JamesTIME COMPLETED:
12:15 PM
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On 1/22/2020 at 11:45 PM, Licensing Program Analysts (LPA's) Francisco Pedroza and Betzayra Cervantes conducted an unannounced Case Management inspection to provide a Stipulation and Waiver. LPA's met with facility Director Karen James and Assistant Director Jennifer Sorensson and advised them the purpose of the inspection. A tour of the facility was conducted inside and out by LPA's and Directors. The facility had 18 children in care at the time of the inspection.

The Stipulation and Waiver CDSS No. (7919051012 and 7919051012B) was provided and reviewed with facility Director Karen James and Assistant Director Jennifer Sorensson.

A1 has been granted a conditional criminal record exemption. The conditional criminal record exemption is only granted for the facility they are currently employed and not transferable. The terms of the conditional exemption were reviewed and advised. The Stipulation and Waiver shall become effective December 13, 2019. It is ordered on December 17, 2019 and expires December 17, 2021.
SUPERVISOR'S NAME: George MingleTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisco PedrozaTELEPHONE: (805) 689-4212
LICENSING EVALUATOR SIGNATURE:

DATE: 01/22/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/22/2020
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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