<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566207503
Report Date: 09/11/2019
Date Signed: 09/11/2019 12:18:13 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:ST. MAXIMILIAN KOLBE'S KORNER PRESCHOOLFACILITY NUMBER:
566207503
ADMINISTRATOR:PAULANN KRUERFACILITY TYPE:
850
ADDRESS:5801 KANAN RD.TELEPHONE:
(818) 874-1241
CITY:WESTLAKE VILLAGESTATE: CAZIP CODE:
91362
CAPACITY:45CENSUS: 28DATE:
09/11/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
11:10 AM
MET WITH:Paulann KruerTIME COMPLETED:
12:30 PM
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) Francisco Pedroza made an unannounced inspection for the purpose of conducting an Annual/Random Inspection. LPA met with facility Director Paulann Kruer and explained the purpose of the inspection. LPA and Director together toured the facility inside and out. The facility currently had 28 children in care at the time of the inspection. The center operates from 9:00 AM to 2:00 PM, Monday thru Friday.

Licensing required notices were posted prominently on the wall at the entrance of the facility. The preschool uses three classrooms for care. Each classroom has it's own restroom with one toilet and sink available for the children to use. LPA did not observe any toxins/hazardous items accessible to children. The classrooms have age appropriate toys and furniture available for children. LPA observed and reviewed the posted snack menu. The center provides a morning and afternoon snack. Some children stay for the afternoon and bring their own lunch from home. The outdoor playground has age appropriate toys and equipment. The playground has an ample amount of shade available. The center has water available for children inside and out. LPA observed children's medications are properly stored. Continued on 809C.
SUPERVISOR'S NAME: George MingleTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisco PedrozaTELEPHONE: (805) 689-4212
LICENSING EVALUATOR SIGNATURE:

DATE: 09/11/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2019
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: ST. MAXIMILIAN KOLBE'S KORNER PRESCHOOL
FACILITY NUMBER: 566207503
VISIT DATE: 09/11/2019
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
26
27
28
29
30
31
32
Administrator advised the center does not have firearms or ammunition at the facility.

Center uses written sign-in/sign-out sheets located at the entrance of each classroom. A sampling of children and staff records were reviewed. Teachers have required qualifications. Teachers present have current First Aid/CPR certificates that expire on 09/03/21. Teachers present have current AB 1207 Mandated Reporter Training certificates that expire on 09/10/21. LPA verified SB 792 Child Care Adult Immunization and Tuberculosis Requirements. Director was provided with and discussed a guide for Safe Sleep and effects of Lead Exposure brochures.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.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 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: 09/11/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2019
LIC809 (FAS) - (06/04)
Page: 2 of 2