561709978-3-3-2023-17-CC-SMAZ-CPKQSN-20230303112549

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 561709978
Report Date: 03/03/2023
Date Signed: 03/03/2023 11:26:04 AM

Document Has Been Signed on 03/03/2023 11:26 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:	MOUNT CROSS CHILD DEVELOPMENT CENTER		FACILITY NUMBER:	561709978
ADMINISTRATOR:	AMY VEGA		FACILITY TYPE:	850
ADDRESS:	102 CAMINO ESPLENDIDO		TELEPHONE:	(805) 482-9706
CITY:	CAMARILLO	STATE: CA	ZIP CODE:	93010
CAPACITY:	57	CENSUS: 51	DATE:	03/03/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:45 AM
MET WITH:	Elizabeth Fox		TIME COMPLETED:	10:29 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	On March 3, 2023 at 9 AM, Licensing Program Analyst (LPA), Susana Martinez conducted an unannounced Required-1 Year annual inspection. LPA met with assistant director Elizabeth Fox and advised her of the purpose for the inspection. Together with the director LPA toured the facility inside and outside. At the time of inspection there were 51 children in care along with 8 fingerprint cleared adults. The facility uses an electronic sign-in/sign-out system called Procare. LPA observed a tablet to be located at the entrance of the facility. LPA also observed the required licensing documents to be accessible to parent's/guardians for viewing. LPA observed todays count on the electronic sign-in/sign-out system and confirmed the census matches the head count. The center operated Mon-Fri from 7:30 AM- 3:30 PM and provides AM and PM snacks for children in care. Children are required to bring lunches from home. LPA observed the outdoor activity space to have sufficient shade and an ample amount of space for the children to play in. The structures and toys were found to be age-appropriate and in good condition. The rooms were found to be free of hazardous/toxic items. LPA observed sufficient age-appropriate toys and learning material. A sampling of 5 children's records were reviewed. All children's files were found to be complete and current. Six employee records were reviewed and found to be complete. At least one employee has a valid Pediatrics CPR/First Aid certification that expires on 8/25/2023. LPA also observed all employees have a valid Mandated Reporter Certification. This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. LPA reminded Elizabeth to follow up with parents regarding expiration dates on medication. Continued on 809-C

SUPERVISOR'S NAME: George Mingle	TELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Susana Martinez	TELEPHONE: 805-689-4212
LICENSING EVALUATOR SIGNATURE:	DATE: 03/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2023

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: MOUNT CROSS CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 561709978
	VISIT DATE: 03/03/2023

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
26
27
28
29
30
31
32

For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.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.

Site supervisor 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.

Web site address to obtain forms, review quarterly updates, review Title 22 & Health & Safety Codes is: https://www.cdss.ca.gov/inforesources/child-care-licensing

No deficiencies were cited during today’s visit.

Notice of Site Visit has been given (LIC9213). The notice shall be posted for 30 consecutive days. Failure to maintain posting as required will result in a $100.00 civil penalty.

Exit interview conducted, appeal rights were given, and report was reviewed with site supervisor Elizabeth Fox.

SUPERVISOR'S NAME: George Mingle	TELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Susana Martinez	TELEPHONE: 805-689-4212
LICENSING EVALUATOR SIGNATURE:	DATE: 03/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2023

LIC809 (FAS) - (06/04)

Page: 2 of 2