561711699-10-14-2019-17-CC-FPEA-BGXQZW-20191014123726

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 561711699
Report Date: 10/14/2019
Date Signed: 10/14/2019 12:37:33 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:	CROSS ROADS CHILDREN'S CENTER		FACILITY NUMBER:	561711699
ADMINISTRATOR:	MICHELLE GORDON		FACILITY TYPE:	850
ADDRESS:	2372 ERRINGER ROAD		TELEPHONE:	(805) 526-2887
CITY:	SIMI VALLEY	STATE: CA	ZIP CODE:	93065
CAPACITY:	120	CENSUS: 49	DATE:	10/14/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	10:45 AM
MET WITH:	Michelle Gordon		TIME COMPLETED:	12:50 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	Licensing Program Analyst (LPA) Francisco Pedroza conducted an unannounced Annual/Random Inspection. LPA met with facility Director Michelle Gordon and explained the purpose of the inspection. LPA and Director together toured the facility inside and out. The facility currently had 49 children in care at the time of the inspection. The center operates from 6:30 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 six classrooms for care. Four of the classrooms have access to a two toilet and one sink restroom. The other two classrooms, children are escorted to a group male and female restrooms each with three to four toilets and two sinks. 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 lunch, morning and afternoon snacks. The outdoor playground has age appropriate toys and equipment. The playground has an ample amount of shade available. The center has water available for children inside and out. Administrator 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: 10/14/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/14/2019

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: CROSS ROADS CHILDREN'S CENTER	FACILITY NUMBER: 561711699
	VISIT DATE: 10/14/2019

NARRATIVE

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Center uses the electronic application Kinder Lime for sign-in/sign-out at the entrance of each classroom. A sampling of children and staff records were reviewed. Teachers have required qualifications. Teachers present have current First Aid/CPR certificates that expire on 12/10/20. Teachers present have current AB 1207 Mandated Reporter Training certificates that expire on 06/07/20. LPAs verified SB 792 Child Care Adult Immunization and Tuberculosis Requirements. Director was provided and discussed with LPA a guide for Safe Sleep and effects of Lead Exposure brochures.

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: 10/14/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/14/2019

LIC809 (FAS) - (06/04)

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