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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 561710890
Report Date: 11/15/2019
Date Signed: 11/15/2019 01:13:05 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:PLEASANT VALLEY CHRISTIAN SCHOOLFACILITY NUMBER:
561710890
ADMINISTRATOR:THERESA BOSHFACILITY TYPE:
850
ADDRESS:1101 PONDEROSA DRIVETELEPHONE:
(805) 484-1188
CITY:CAMARILLOSTATE: CAZIP CODE:
93010
CAPACITY:63CENSUS: 51DATE:
11/15/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Theresa FloydTIME COMPLETED:
01:15 PM
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Licensing Program Analyst (LPA) Laura Villanueva made an unannounced visit in order to conduct an Annual Random review and met with the Director, Theresa Floyd. The purpose of the visit was discussed and a tour of the facility was conducted. The center operates from 7:30 AM to 5:00 PM Monday through Friday. The center is on the elementary school calendar.

The center uses 5 classrooms for the Preschool. LPA toured these classrooms and found them free of toxins and hazards. There was drinking water available both inside and outside the classrooms. Playground toured was fully fenced with enough cushion under high climbing equipment. The center does not provide snacks. The children bring their own snacks and lunch. A hot lunch may be purchased from the elementary school. Fridays are pizza day for all the children. Menus are posted at the entrance of the center. Staff present have also obtained a Criminal Record Clearance. Immunization requirement (SB792) for staff was verified through review of records and staff was found compliant. Staff has completed Mandated Reporter Training. CPR/First aid certification for staff was current with an expiration date of 10/22/21.

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 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

There were no deficiencies cited for today's visit.

A notice of site visit was provided.

SUPERVISOR'S NAME: George MingleTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Laura VillanuevaTELEPHONE: (805) 722-5138
LICENSING EVALUATOR SIGNATURE:

DATE: 11/15/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2019
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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