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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566207389
Report Date: 09/07/2021
Date Signed: 09/07/2021 02:50:18 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:VENTURA BRANCH - LOMA VISTA ELEMENTARYFACILITY NUMBER:
566207389
ADMINISTRATOR:JULIE O'BRIENFACILITY TYPE:
840
ADDRESS:300 LYNN DR.TELEPHONE:
(805) 256-2475
CITY:VENTURASTATE: CAZIP CODE:
93003
CAPACITY:55CENSUS: 20DATE:
09/07/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Diana DiamondTIME COMPLETED:
03:00 PM
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On 09/07/2021 @ 12:30 PM an annual required 1 year inspection was conducted in addition an evaluation for an increase of capacity and use of classroom #19. A risk assessment for COVID-19 was conducted prior to entry into the program. LPA S. Mendoza-Ceja met with Diana Diamond and Cynthia Butler-Ngiratmab, during the inspection the Youth Programs Director Julie O'brien arrived.

The school age program operates on the grounds of Loma Vista Elementary School and relocated to classroom #19. LPA inspected the classroom and the outside playground area. LPA observed the classroom to be clean and orderly. LPA observed water available inside and outside. The restrooms were also inspected and it was found to have ants. LPA was advised the school is aware and currently working on this issue.

LPA was advised there is no medication being administered at this time. LPA reviewed children's records for emergency contact information and the electronic sign in/out utilizing E Pact. LPA reviewed the appropriate documents posted for review which includes the Snack Menu, Parent Rights, Personal Rights, and COVID-19. Staff qualifications were reviewed including AB 1207 Child Abuse Mandated Reporter Training, Health Screening, and verification of current with Pediatric CPR and First Aid for one staff.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing 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

The licensure and increase of capacity for classroom #19 is pending further review. The Notice of Site Visit was posted at the visit.

FAILURE TO POST THE NOTICE OF SITE VISIT FOR 30 DAYS MAY RESULT IN A $100.00 CIVIL PENALTY.

SUPERVISOR'S NAME: Ana TolentinoTELEPHONE: (805) 562-0437
LICENSING EVALUATOR NAME: Sylvia Mendoza-CejaTELEPHONE: (805) 722-5132
LICENSING EVALUATOR SIGNATURE:

DATE: 09/07/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/07/2021
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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