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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566207651
Report Date: 07/19/2023
Date Signed: 07/19/2023 02:21:55 PM


Document Has Been Signed on 07/19/2023 02:21 PM - 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:GREAT PACIFIC CHILD DEVELOPMENT CENTERFACILITY NUMBER:
566207651
ADMINISTRATOR:JESSICA DERBYFACILITY TYPE:
850
ADDRESS:259 WEST SANTA CLARA STREETTELEPHONE:
(805) 507-8335
CITY:VENTURASTATE: CAZIP CODE:
93001
CAPACITY:105CENSUS: 37DATE:
07/19/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Jessica erbyTIME COMPLETED:
02:36 PM
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On July 19, 2023 Licensing Program Analyst (LPA) Susana Martinez conducted an unannounced case management- licensee initiated inspection. LPA met with site director Jessica Derby and advised her of the purpose for the inspection. Together with the director LPA toured the facility inside and outside. At the time of the inspection there were 37 children in the care of 9 adults. No bodies of water were observed at the time of inspection.

The center submitted an application requesting to decrease the capacity to 91 children. The center uses 4 rooms for care which are labeled: Pelicans, Jellyfish, Dolphins and Penguins. The day-care children have access to three outdoor areas.

Based on the overall indoor/outdoor square footage, toilets and sinks, the center meets the requirement for 91 children.

The decrease of capacity for 91 children is effective July 19, 2023.

Director was made aware that it is the facility's responsibility to know the current regulations for a CCC which can be accessed on-line at www.cdss.ca.gov


A notice of site visit was given and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview was conducted and report was reviewed with the director Jessica Derby.

SUPERVISOR'S NAME: George MingleTELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Susana MartinezTELEPHONE: 805-689-4212
LICENSING EVALUATOR SIGNATURE:
DATE: 07/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/19/2023
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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