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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566203004
Report Date: 05/09/2019
Date Signed: 05/09/2019 11:03:15 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:CDI - SHERIDAN WAY CHILDREN'S CENTERFACILITY NUMBER:
566203004
ADMINISTRATOR:RACHEL CHAMPAGNEFACILITY TYPE:
840
ADDRESS:573 SHERIDAN WAYTELEPHONE:
(805) 643-9458
CITY:VENTURASTATE: CAZIP CODE:
93001
CAPACITY:35CENSUS: 0DATE:
05/09/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
10:31 AM
MET WITH:Jazmin LopezTIME COMPLETED:
11:10 AM
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Licensing Program Analysts (LPAs) Francisco Pedroza and Jill Laxo made an unannounced inspection to conduct an Annual/Random inspection. LPAs met with Site Supervisor Jasmin Lopez. LPA's explained the nature of the inspection and together conducted a tour of the facility inside and out. The center operates from 6:30 AM to 6:00 PM, Monday - Friday. This is a combined center with a Preschool Program.

At the time of the inspection there was no School Age children being supervised. School Age children arrive around 6:30 AM and leave for school. Children gradually arrive at 1:00 PM and 2:30 PM to work on their school assignments and play with other children until their parents pick them up. The facility has an approved waiver allowing the children to commingle for hour in the morning and evening.

The School Age classroom has one restroom. LPAs did not observe any toxins/hazardous items accessible to children. LPAs reviewed the posted breakfast, lunch and snack menu. Kitchen, food preparation, storage area are kept clean, free of litter. Food is properly labeled and dated. The facility has a playground with age appropriate toys and equipment. Continued on 809C
SUPERVISOR'S NAME: George MingleTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisco PedrozaTELEPHONE: (805) 689-4212
LICENSING EVALUATOR SIGNATURE:

DATE: 05/09/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 2
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: CDI - SHERIDAN WAY CHILDREN'S CENTER
FACILITY NUMBER: 566203004
VISIT DATE: 05/09/2019
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Site Supervisor Lopez advised that after normal school hours the facility is authorized to use the school's outdoor playgrounds. There is drinking water available both inside and outside for the children.

Center uses written sign-in/sign-out sheets. A sampling of children and staff records were reviewed. Teachers have required qualification. Teachers present have current First Aid/CPR certificates. LPA verified SB 792 Child Care Adult Immunization and Tuberculosis Requirements. AB 1207 Mandated Reporter Training certificates current.

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

No deficiencies were cited during today's visit.



The LIC 9213 (Notice of Site Visit) was posted during the visit.
SUPERVISOR'S NAME: George MingleTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisco PedrozaTELEPHONE: (805) 689-4212
LICENSING EVALUATOR SIGNATURE:

DATE: 05/09/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2019
LIC809 (FAS) - (06/04)
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