<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 561709946
Report Date: 08/21/2020
Date Signed: 08/24/2020 01:01:39 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:CDI - MOUND SCHOOL AGE CHILD DEVELOPMENT CENTERFACILITY NUMBER:
561709946
ADMINISTRATOR:DEBORAH DORFMANFACILITY TYPE:
840
ADDRESS:455 S. HILL RD.TELEPHONE:
(805) 650-8791
CITY:VENTURASTATE: CAZIP CODE:
93003
CAPACITY:79CENSUS: 16DATE:
08/21/2020
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
10:45 AM
MET WITH:Robin TooleTIME COMPLETED:
11:30 AM
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
A case management inspection was conducted by Licensing Program Analyst (LPA) S. Mendoza-Ceja conducted an unannounced tele-inspection. LPA S. Mendoza-Ceja met with Center Manager Robin Toole who requested an inspection by the Department. LPA advised due to COVID-19 and Department of Public Health (DPH) guidelines of social distancing, a tele-inspection will be conducted.

LPA S. Mendoza-Ceja conducted a virtual Tele-Inspection via Facetime with Center Manager Robin Toole. The purpose of the inspection was to evaluate the changes made within the classroom #2 using furniture and shelves to accommodate two separate groups of children on each side of the classroom. LPA observed, the center re-organized the furniture, tables, chairs, including marking areas such as chairs and the ground to show how the children will be encouraged to maintain physical distancing. LPA also observed the outdoor playground area.

The Center Manager Robin Toole stated there had been no changes to classroom #1 or the licensed capacity.

This report will be sent to Licensee via email with a read receipt for confirmation of receipt of email, Licensee will need to sign and return via email or regular mail to LPA S. Mendoza-Ceja.
SUPERVISOR'S NAME: Ana TolentinoTELEPHONE: (805) 562-0437
LICENSING EVALUATOR NAME: Sylvia Mendoza-CejaTELEPHONE: (805) 722-5132
LICENSING EVALUATOR SIGNATURE:

DATE: 08/21/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/21/2020
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 1