561711931-9-28-2022-17-CC-RCHZ-CJPQ7T-20220928115542

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 561711931
Report Date: 09/28/2022
Date Signed: 09/28/2022 11:55:54 AM

Document Has Been Signed on 09/28/2022 11:55 AM - It Cannot Be Edited

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: 15	DATE:	09/28/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:55 AM
MET WITH:	Ruth Valencia		TIME COMPLETED:	10:52 AM

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On September 28, 2022 at 9:03 AM, Licensing Program Analyst (LPA) Rona Chavez conducted a required unannounced annual inspection. Facility is located at Montalvo Elementary School campus. LPA met with Site Supervisor Ruth Valencia and was provided a tour of the facility inside and out. There were 15 children in care at the time of the inspection and three (3) staff. The center operates 8:00 AM - 3:00 PM, Monday through Friday. Center provides an 3 hour morning and afternoon session.

Licensing required notices were posted prominently on the wall in the entrance of the classroom. The facility uses one (1) classroom. The classroom has age appropriate toys and furniture available for children. LPA did not observe any toxins/hazardous items accessible to children. The outdoor playground is completely enclosed by a fence and separate from the school children. LPA observed age appropriate toys and play structures. The preschool has designated restrooms for use of the center children only. Bathrooms were observed to be clean and free of toxins. There is water readily available inside and outside. LPA observed menu posted, center provides breakfast and lunch. Food is prepared in the school cafeteria. There is a functioning carbon monoxide detector and first aid kit in the classroom.

Cont on LIC 809-C

SUPERVISOR'S NAME: Ana Tolentino	TELEPHONE: (805) 562-0437
LICENSING EVALUATOR NAME: Rona Chavez	TELEPHONE: (424) 299-1480
LICENSING EVALUATOR SIGNATURE:	DATE: 09/28/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2022

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: 09/28/2022

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Center uses written sign in and out sheets. The last recorded fire drill was conducted on 9/8/2022. A sampling of children and staff records were reviewed and found current. Currently the facility does not have children that require Incidental Medical services (IMS). At least one staff present has current Pediatric First Aid/CPR certificates that expire on 9/30/2023. Teachers present have current AB1207 Mandated Reporter Training certificates that expire on 9/27/2023.

No deficiencies were cited during today's inspection.

Site Supervisor was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment

SUPERVISOR'S NAME: Ana Tolentino	TELEPHONE: (805) 562-0437
LICENSING EVALUATOR NAME: Rona Chavez	TELEPHONE: (424) 299-1480
LICENSING EVALUATOR SIGNATURE:	DATE: 09/28/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2022

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: 09/28/2022

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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.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Site Supervisor Ruth Valencia.

SUPERVISOR'S NAME: Ana Tolentino	TELEPHONE: (805) 562-0437
LICENSING EVALUATOR NAME: Rona Chavez	TELEPHONE: (424) 299-1480
LICENSING EVALUATOR SIGNATURE:	DATE: 09/28/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2022

LIC809 (FAS) - (06/04)

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