561711931-10-15-2019-17-CC-JMHL-BGYPC9-20191015111134

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 561711931
Report Date: 10/15/2019
Date Signed: 10/15/2019 11:11:41 AM

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:	VUSD - JUMPSTART (MONTALVO)		FACILITY NUMBER:	561711931
ADMINISTRATOR:	LORETTA GALAVIZ		FACILITY TYPE:	850
ADDRESS:	2050 GRAND AVENUE		TELEPHONE:	(805) 289-1872
CITY:	VENTURA	STATE: CA	ZIP CODE:	93003
CAPACITY:	24	CENSUS: 22	DATE:	10/15/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Ruth Valencia		TIME COMPLETED:	11:30 AM

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) Jill Laxo conducted an unannounced annual inspection and met with site supervisor Ruth Valencia. The purpose of the inspection was discussed and one preschool classroom was toured and the designated outside play area. There were 3 teachers supervising 22 children. Bathrooms were in safe and sanitary condition and free of hazards. Classroom was adequately equipped with age and size appropriate furniture and equipment was in good condition. Sign in and out sheets contained signatures and times. Breakfast and Lunch are provided through the school and a monthly menu is posted at the classroom door. Disinfectants and cleaning supplies are stored in an upper cabinet inaccessible to children. Drinking water was readily available both indoors and out. Emergency drills are conducted through the school and the next is scheduled for the week ending 10/18/2019. The playground was enclosed with climbing equipment on cushioned material. The play equipment is in good condition and was free of hazards. There were no bodies of water. Director stated there are no guns nor ammunition in the classroom. Personnel records were viewed and contained documents for education, AB 1207 expires on 04/12/2020, CPR/First Aid expires 12/06/2020, Staff immunization records were reviewed. Children records contained authorized representative contact information.

SUPERVISOR'S NAME: Ana Tolentino	TELEPHONE: (805) 562-0347
LICENSING EVALUATOR NAME: Jill M Hazelhofer-Laxo	TELEPHONE: (805) 635-5097
LICENSING EVALUATOR SIGNATURE:	DATE: 10/15/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2019

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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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: VUSD - JUMPSTART (MONTALVO)	FACILITY NUMBER: 561711931
	VISIT DATE: 10/15/2019

NARRATIVE

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The site supervisor stated there are no medications administered at this time.

Incidental Medical Services (IMS) policy was discussed. 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

Lead Exposure brochures were provided.

No deficiencies were cited during today's visit

THE NOTICE OF SITE VISIT WAS POSTED.

SUPERVISOR'S NAME: Ana Tolentino	TELEPHONE: (805) 562-0347
LICENSING EVALUATOR NAME: Jill M Hazelhofer-Laxo	TELEPHONE: (805) 635-5097
LICENSING EVALUATOR SIGNATURE:	DATE: 10/15/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2019

LIC809 (FAS) - (06/04)

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