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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 561711304
Report Date: 02/13/2020
Date Signed: 02/13/2020 03:28:01 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:LAS POSAS CHILDREN'S CENTER @ SERRA ELEMENTARYFACILITY NUMBER:
561711304
ADMINISTRATOR:ROBERT ALFINOFACILITY TYPE:
840
ADDRESS:8880 HALIFAX STREETTELEPHONE:
(805) 659-4115
CITY:VENTURASTATE: CAZIP CODE:
93004
CAPACITY:99CENSUS: 65DATE:
02/13/2020
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
03:09 PM
MET WITH:Diana ShillingtonTIME COMPLETED:
03:30 PM
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On 02/13/20 at 3:09pm, Licensing Program Analyst made and unannounced inspection to the facility in order to conduct a Case Management visit for an incident which occurred on 01/09/2020. On 01/09/2020, C1 came to the after school program at 2:32pm wheezing after completing a fun run at school earlier in the day. C1 had previously done one breathing treatment at 1:30pm after the run. C1 exhibited clammy, cramping hands and had difficulty breathing. Staff called the school Health Tech for advice. The Health Tech called C1's family and helped calm down the child. Staff called 911 for medical advice. The paramedics recommended one more breathing treatment be administered while responders made their way to the campus. The paramedics as well as C1's family arrived and the child was evaluated at 3:10pm. Paramedics recommended the child be taken to the hospital for evaluation. The child was transported to the hospital via ambulance and the family followed. The child has previously diagnosed Asthma but has never elevated to this level prior to this date.

Following the incident, a plan was enacted for staff to immediately contact the family and paramedics if C1 elevates to this level again. A paper bag is kept at the facility for the child to use to help regulate breathing if C1 needs.
SUPERVISOR'S NAME: Ana TolentinoTELEPHONE: (805) 562-0347
LICENSING EVALUATOR NAME: Christian PattersonTELEPHONE: (805) 315-8362
LICENSING EVALUATOR SIGNATURE:

DATE: 02/13/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2020
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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