561710730-10-10-2019-17-CC-FPEA-BGTS7X-20191010133816

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 561710730
Report Date: 10/10/2019
Date Signed: 10/10/2019 01:38:25 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:	ROOTS & WINGS FAMILY DEVELOPMENT CENTER		FACILITY NUMBER:	561710730
ADMINISTRATOR:	ELIZABETH STRASSWYK		FACILITY TYPE:	850
ADDRESS:	1492 CALLE TULIPAN		TELEPHONE:	(805) 492-8560
CITY:	THOUSAND OAKS	STATE: CA	ZIP CODE:	91360
CAPACITY:	43	CENSUS: 22	DATE:	10/10/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	12:15 PM
MET WITH:	Michelle Wilcox		TIME COMPLETED:	01:20 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	(1) Licensing Program Analyst (LPA) Francisco Pedroza made an unannounced inspection for the purpose of conducting an Annual/Random Inspection. LPA met with facility Director Michelle Wilcox and explained the purpose of the visit. LPA and Director together toured the facility inside and out. The facility currently had 22 children in care at the time of the inspection. The center operates from 7:00 AM to 6:00 PM, Monday thru Friday. Licensing required notices were posted prominently on the wall at the entrance of the facility. The preschool uses three classrooms for care. LPA did not observe any toxins/hazardous items accessible to children. The classrooms have age appropriate toys and furniture available for children. LPA observed and reviewed the posted snack menu. The center provides a morning and afternoon snack. Children bring a packed lunch from home. The outdoor playground has age appropriate toys and equipment. The playground has an ample amount of shade available. There are three storage units filled with toys and school supplies in the yard. The center has water available for children inside and out. Facility Director advised the center does not have firearms or ammunition at the facility. Continued on 809C.

SUPERVISOR'S NAME: George Mingle	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisco Pedroza	TELEPHONE: (805) 689-4212
LICENSING EVALUATOR SIGNATURE:	DATE: 10/10/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2019

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: 10/10/2019

NARRATIVE

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Center uses the electronic application Bright Wheel for sign-in/sign-out at the entrance of the building. A sampling of children and staff records were reviewed. Teachers have required qualifications. Teachers present have current First Aid/CPR certificates that expire on 08/11/20. Teachers present have current AB 1207 Mandated Reporter Training certificates that expire on 08/13/20. LPA verified SB 792 Child Care Adult Immunization and Tuberculosis Requirements.

Incidental Medical Services (IMS) policy was discussed and currently the center does have children with IMS. Plan of Operations on file. 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.

No deficiencies were cited during today's visit.

THE NOTICE OF SITE VISIT WAS POSTED AS REQUIRED BY H&S CODE SEC. 1596.817. THE NOTICE OF SITE VISIT MUST REMAIN POSTED FOR 30 DAYS OR A CIVIL PENALTY OF $100.00 WILL APPLY.

SUPERVISOR'S NAME: George Mingle	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisco Pedroza	TELEPHONE: (805) 689-4212
LICENSING EVALUATOR SIGNATURE:	DATE: 10/10/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2019

LIC809 (FAS) - (06/04)

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