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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 561700773
Report Date: 05/26/2022
Date Signed: 05/26/2022 11:46:22 AM


Document Has Been Signed on 05/26/2022 11:46 AM - 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: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: 2DATE:
05/26/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
07:27 AM
MET WITH:Jennifer SorenssonTIME COMPLETED:
09:17 AM
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On 5/26/2022 at 8:00 AM , Licensing Program Analyst (LPA) Dean Thompson conducted an unannounced Case Management - Incident inspection. LPA met with facility Director Jennifer Sorensson and advised her the purpose of the inspection. Director provided LPA a tour of the facility inside and out. There were two children in care at the time of the inspection.

On 5/20/2022 Director Jennifer Sorensson contacted Community Care Licensing (CCL) to self-report an incident of a day care child tripping on his own and breaking his arm during the fall. The Director reported the incident and submitted the unusual incident report to the Department as required. C1 returned to care on 5/24/2022.

LPA observed the area where in the incident took place inside the classroom. LPA observed classroom surface to be safe and clean. There were two staff inside the classroom during the incident and eleven (11) children. Staff observed where the incident take place and attended to the child. Director called C1 parents and informed them of the incident.

Based on the information obtained, it is determined no violations have occurred, thus no deficiencies are cited during todays inspection.

A notice of site visit was given.

Failure to Post the Notice of Site Visit for 30 days may result in a $100.00 Civil Penalty.

THE NOTICE OF SITE VISIT WAS POSTED AS REQUIRED BY H&S CODE SEC. 1596.817

SUPERVISOR'S NAME: George MingleTELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Dean ThompsonTELEPHONE: (805) 729-8797
LICENSING EVALUATOR SIGNATURE:
DATE: 05/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/26/2022
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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