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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566208209
Report Date: 06/04/2024
Date Signed: 06/04/2024 11:36:09 AM


Document Has Been Signed on 06/04/2024 11:36 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117



FACILITY NAME:GRACE BRETHREN PRESCHOOL EASTFACILITY NUMBER:
566208209
ADMINISTRATOR:JULIA CHANDLERFACILITY TYPE:
850
ADDRESS:2762 AVENIDA SIMITELEPHONE:
(805) 582-4270
CITY:SIMI VALLEYSTATE: CAZIP CODE:
93065
CAPACITY:136CENSUS: DATE:
06/04/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:40 AM
MET WITH:Dawn Munden TIME COMPLETED:
11:50 AM
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On June 4, 2024 at 9:40 AM, Licensing Program Analyst (LPA) Aaliyah Zendejas conducted a case management - incident inspection at the Child Care Center (CCC) for the purpose of following up on an unusual incident report received by the department on 5/12/2024. The incident was regarding a child who was left unsupervised and was then returned to care by a parent of another child attending the CCC. LPA met with Assistant Director Sandy Smith to discuss the purpose of the inspection. Assistant Director stated that the director, Dawn was in a meeting elsewhere but would return if needed. LPA observed 10 children under the care and supervision of 1 staff member in the classroom that the incident occurred.

Director Dawn Munden informed Licensing that while transitioning students, C1 had been left in the bathroom area. S1 had counted the students before leaving the bathroom and then recounted again once entering the classroom. By the time S1 realized that there was a child missing, a parent on campus had found the child and returned them to the classroom. Administration was immediately notified. C1 is still enrolled at the facility.

By 10:30 AM, Director Dawn Munden arrived at the facility and LPA informed them about the reason for the visit and asked about the training's they were supposed to be conducting. LPA obtained copies of the agenda which had notes regarding Supervision of Students as well as the three- check count system which previous LPA had advised Director to train staff on. LPA observed the cameras from the day of the incident and saw that at 12:53.33 PM the child was left unattended by the substitute and then at 12:56 PM was back in supervision. LPA interviewed staff who stated that they have been learning and implementing practices for better supervision of children such as counting multiple times, have clipboards always in hand to check children off, and doing the three checks system with children.

During today’s inspection, no deficiencies were cited.
Exit interview and review of report was conducted with Director Dawn Munden. Notice of Site visit was provided and must remain posted for the next 30 days.
SUPERVISOR'S NAME: George MingleTELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Aaliyah ZendejasTELEPHONE: (805) 722-5133
LICENSING EVALUATOR SIGNATURE:
DATE: 06/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/04/2024
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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