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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566208149
Report Date: 05/12/2022
Date Signed: 05/12/2022 12:21:10 PM


Document Has Been Signed on 05/12/2022 12:21 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:HOLY CROSS PRESCHOOL AT SAN BUENA VENTURA MISSIONFACILITY NUMBER:
566208149
ADMINISTRATOR:BRENDA AMBRIZ CORTEZFACILITY TYPE:
850
ADDRESS:183 E. MAIN ST.TELEPHONE:
(805) 643-1500
CITY:VENTURASTATE: CAZIP CODE:
93001
CAPACITY:24CENSUS: 22DATE:
05/12/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Brenda CortezTIME COMPLETED:
10:00 AM
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On May 12, 2022 Licensing Program Analysts (LPAs) Dean Thompson, Susana Martinez, Austin Rios conducted an unannounced Case Management inspection. Prior to entering the facility, LPAs conducted Covid-19 screening questions. LPAs met with facility Director Brenda Cortez and advised her the purpose of the inspection. Director provided LPAs a tour of the facility inside and out. There were 22 children in care at the time of the inspection.

Community Care Licensing (CCL) received an approved fire clearance from Ventura County Fire Department on April 15, 2022. The facility requested an increase in capacity from 24 to 48 children.

Facility Measurements:

Indoor - 1,984 square footage meets and exceeds the requirement for 48 children.

Outdoor - 1,452 square footage does not meet or exceed the requirement for 48 children.

The center does not meet Title 22 Division 12 requirements for a change of capacity of 48 Pre-School children based on outdoor playground square footage.



As of today, May 12, 2022 licensee maximum capacity is 24 pre-school children. Director was advised to submit a waiver for the outdoor playground area.

THE NOTICE OF SITE VISIT WAS POSTED AS REQUIRED BY H&S CODE SEC. 1596.817.
SUPERVISOR'S NAME: George MingleTELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Dean ThompsonTELEPHONE: (805) 729-8797
LICENSING EVALUATOR SIGNATURE:
DATE: 05/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/12/2022
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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