561703051-4-7-2023-17-CC-SMAZ-CLLUHA-20221128143538

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 561703051
Report Date: 11/28/2022
Date Signed: 04/07/2023 08:44:01 AM

Document Has Been Signed on 04/07/2023 08:44 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:	CDR - BENITA WALLICK HEAD START		FACILITY NUMBER:	561703051
ADMINISTRATOR:	SUZANNE GODINEZ		FACILITY TYPE:	850
ADDRESS:	2717 NORTH VENTURA AVENUE		TELEPHONE:	(805) 648-3083
CITY:	VENTURA	STATE: CA	ZIP CODE:	93001
CAPACITY:	40	CENSUS: 13	DATE:	11/28/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:54 AM
MET WITH:	Rita Ortiz		TIME COMPLETED:	01:15 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On November 28, 2022 at 11:54 AM, Licensing Program Analyst (LPA) Susana Martinez and Licensing Program Manager (LPM) George Mingle conducted an unannounced required 1 year inspection. LPA and LPM met with teacher Margarita "Rita" Ortiz and advised the reason for the inspection. At the time of the inspection there were 13 children present and 5 staff members. LPA, LPM and Rita toured the facility inside and outside. The center operates Monday- Friday from 8 am- 2pm. The center uses two rooms for care; Room F and Room G. Room F was observed to be free of toxins/hazardous items. The room had sufficient toys and learning materials available for children in care including a tippy for quiet time. A dual carbon monoxide and smoke detector was observed to be mounted on the wall next to the bathrooms. This room has 2 toilets and 2 sink. Licensing requirements were posted at the entrance of the room. LPA observed the last disaster drill to be conducted on 10/20/22. Room G was also observed to be free of toxins/hazardous items. The dual carbon monoxide and smoke alarm was observed to be in working condition. This room also has 2 toilets and 2 sink. LPA observed the last disaster drill to be conducted on 11/21/2022. The center uses an electronic sign-in and sign-out system called Child Plus. No bodies of water were observed at the time of the inspection. The center provides snacks and lunch. The outdoor area has sufficient age-appropriate toys and play structures. The main play structure is surrounded by sand. The outdoor area has a paved walkway surrounding the sand area. LPA reviewed a sampling of children's files which were found to be complete and current. LPA also reviewed staffs files which were found complete and to date. Continued 809-C

SUPERVISOR'S NAME: George Mingle	TELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Susana Martinez	TELEPHONE: 805-689-4212
LICENSING EVALUATOR SIGNATURE:	DATE: 11/28/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/28/2022

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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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: CDR - BENITA WALLICK HEAD START	FACILITY NUMBER: 561703051
	VISIT DATE: 11/28/2022

NARRATIVE

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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

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process.

Director was reminded that all adults 18 and over, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

No deficiencies were cited today.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted, appeal rights were given, and report was reviewed with teacher Rita Ortiz.

SUPERVISOR'S NAME: George Mingle	TELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Susana Martinez	TELEPHONE: 805-689-4212
LICENSING EVALUATOR SIGNATURE:	DATE: 11/28/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/28/2022

LIC809 (FAS) - (06/04)

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