561710730-10-16-2024-17-CC-EBAY-DA4SBZ-20241016134445

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 561710730
Report Date: 10/16/2024
Date Signed: 10/16/2024 01:44:54 PM

Document Has Been Signed on 10/16/2024 01:44 PM - 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:	ROOTS & WINGS FAMILY DEVELOPMENT CENTER		FACILITY NUMBER:	561710730
ADMINISTRATOR:	MICHELLE WILCOX		FACILITY TYPE:	850
ADDRESS:	1492 CALLE TULIPAN		TELEPHONE:	(805) 492-8560
CITY:	THOUSAND OAKS	STATE: CA	ZIP CODE:	91360
CAPACITY:	43	CENSUS: 23	DATE:	10/16/2024
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	11:30 AM
MET WITH:	Beatriz Magdaleno		TIME COMPLETED:	02:00 PM

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On 10/16/24, at 11:30 AM, Licensing Program Analyst (LPA) Elvin Baddley conducted an unannounced Three Year Required inspection of the abovementioned Child Care Center (CCC). LPA met with Beatriz Magdaleno, Director of the CCC. LPA explained the purpose and nature of the inspection. The Preschool operates Monday- Friday from 7:30 AM – 5:30 PM. The facility uses three classrooms for child care services; Dragonfly Creative Room (3.5-5 years of age), Dragonfly Skill Room (3.5-5 years of age) and the Hummingbird Room (2-3 years of age). At the time of inspection, LPA observed 23 children on site, along with four teachers (cleared and associated). The CCC's Director is assisting with the care and supervision of children on site.

LPA observed required licensing forms and documents posted near the CCC's kitchen. The CCC also has activities and a menu posted for view. The CCC uses an electronic Sign In/Out system (Brightwheel). LPA reviewed a sample of the system's entries and notes the entries contain the arrival and departure times of children in care and well as the electronic entry of children's authorized representatives conducting the given Sign In/Out. The classrooms have age appropriate equipment and furnishings available to children in care. The CCC has multiple carbon monoxide detectors throughout the CCC. LPA tested a carbon monoxide detector in the Hummingbird Room at 12:08 PM and found the carbon monoxide detector to be operable. The CCC restroom was observed to be in safe and sanitary operating condition. The CCC has a changing table for children still wearing/using diapers. The CCC has a refrigerator in the kitchen area, which stores food and beverages for children in care. Lunches are provided by the parents of children in care. The CCC provides morning and afternoon snacks. The CCC has available (filtered) drinking water for children inside and outside of the facility. Children are also able to bring drinking water from homes into the CCC. CCCs constructed before 1/1/20, to test their water (used for drinking and food preparation) for lead contamination before 1/1/23, and then every 5 years after the date of the first test. For CCC licenses issued after 7/1/22, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP). LPA verified the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

(CONT. LIC 809-C, Page 2)

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Elvin Baddley	TELEPHONE: (805) 635-4697
LICENSING EVALUATOR SIGNATURE:	DATE: 10/16/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2024

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: ROOTS & WINGS FAMILY DEVELOPMENT CENTER	FACILITY NUMBER: 561710730
	VISIT DATE: 10/16/2024

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Medication, disinfectants, sharps and cleaning solutions are located in kitchen cabinets in the CCC. The cabinets are secure and/or in elevated locations, which are accessible to staff members and inaccessible to children in care. The CCC has available Fist Aid Kits. LPA observed waste receptacles with tight fitting lids.

The CCC outdoor playground areas are enclosed by a combination wrought iron, wood and cider block fencing. The fence’s entry/exit gates are secured. The surfaces of the outdoor playground areas are varied. LPA observed one shed in the outdoor area which contains CCC's supplies. The shed is secured. LPA observed another shed in a partitioned section of the outdoor area which is not accessible to children in care. LPA observed age appropriate play equipment in the play areas. The play equipment is free of sharp, loose or pointed objects. The play structures in the outdoor playground areas have adequate cushioning materials to absorb falls and shade created by building overhangs, large trees and shade sails. LPA reminded Director to replace outdoor play equipment and furnishings when such items begin to degrade or are not in good repair. LPA observed no bodies of water at the CCC.

LPA reviewed children, staff and facility records. The children’s records sampled were complete and found to contain emergency contact information and immunization records, among other required licensing documentation and forms. Staff records were reviewed. Staff records sampled were complete and found to contain First Aid/CPR certifications (EMSA approved) and Mandated Reporter Training certification, among other required licensing documentation and forms. LPA notes the last disaster drill at the facility occurred on 9/24/24. No firearms or ammunition are stored on site.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of “medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication. Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

Facility representative was reminded that all adults 18 and over, including employees and volunteers,
as specified in HSC section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a (CONT> LIC 809-C, Page 3)

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Elvin Baddley	TELEPHONE: (805) 635-4697
LICENSING EVALUATOR SIGNATURE:	DATE: 10/16/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2024

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: ROOTS & WINGS FAMILY DEVELOPMENT CENTER	FACILITY NUMBER: 561710730
	VISIT DATE: 10/16/2024

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repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Facility representative Beatriz Magdaleno.

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Elvin Baddley	TELEPHONE: (805) 635-4697
LICENSING EVALUATOR SIGNATURE:	DATE: 10/16/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2024

LIC809 (FAS) - (06/04)

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