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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566203929
Report Date: 01/09/2020
Date Signed: 01/09/2020 10:59:10 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:LITTLE DREAMERS EARLY CHILDHOOD CENTERFACILITY NUMBER:
566203929
ADMINISTRATOR:VALERIO, ROSANGELAFACILITY TYPE:
850
ADDRESS:3277 FOOTHILL DR.TELEPHONE:
(805) 379-3798
CITY:THOUSAND OAKSSTATE: CAZIP CODE:
91361
CAPACITY:115CENSUS: 61DATE:
01/09/2020
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:10 AM
MET WITH:Rosangela ValerioTIME COMPLETED:
11:15 AM
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Licensing Program Analyst (LPA) Frank Pedroza conducted an unannounced Case Management inspection. LPA met with facility Director Rosangela Valerio and discussed the purpose of the inspection. LPA and Director conducted a tour of the facility inside and out. There were 61 children in care at the time of the inspection.

On 12/11/2019, facility contacted Community Care Licensing (CCL) to self report an incident of a child sustaining an injury while in care. A child was climbing up a wall mounted rock climbing wall. The child had fell landing on their feet on the padded mats placed in front of the wall. After landing the child immediately fell back and started to cry. Staff responded to assist the child and provided her with an ice pack. Staff contacted the child's guardian recommending that she receive a medical evaluation. The child's guardian picked her up and scheduled a doctor appointment.

The child was diagnosed with a fractured tibia and fibula on their right leg. She was placed in a full cast. The child has not returned back to the facility. They had a follow-up appointment with the doctor yesterday 1/08/2020. Director advised parent that they will require a doctors note advising what the child's restrictions are prior to returning to ensure they can address the needs of the child.

Continued on 809C

SUPERVISOR'S NAME: George MingleTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisco PedrozaTELEPHONE: (805) 689-4212
LICENSING EVALUATOR SIGNATURE:

DATE: 01/09/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/09/2020
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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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: LITTLE DREAMERS EARLY CHILDHOOD CENTER
FACILITY NUMBER: 566203929
VISIT DATE: 01/09/2020
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LPA observed where the child had fallen. LPA requested facility staff provide CCL a copy of the doctor note with the child's restrictions once received and their plan on how to address the child's needs. Given the Director's account of the incident when reporting it to CCL and how they addressed the incident, LPA deemed facility's actions were appropriate.

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 MingleTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisco PedrozaTELEPHONE: (805) 689-4212
LICENSING EVALUATOR SIGNATURE:

DATE: 01/09/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/09/2020
LIC809 (FAS) - (06/04)
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