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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566208287
Report Date: 03/03/2023
Date Signed: 03/03/2023 12:31:16 PM


Document Has Been Signed on 03/03/2023 12:31 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:VUSD - PORTOLA JUMPSTART STATE PRESCHOOL PROGRAMFACILITY NUMBER:
566208287
ADMINISTRATOR:NEOMI JIMENEZFACILITY TYPE:
850
ADDRESS:6700 EAGLE ST.TELEPHONE:
(805) 289-1734
CITY:VENTURASTATE: CAZIP CODE:
93003
CAPACITY:24CENSUS: 0DATE:
03/03/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:06 AM
MET WITH:Noemi JimenezTIME COMPLETED:
12:49 PM
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On March 3, 2023 at 11:06 AM Licensing Program Analyst (LPA) Rona Chavez conducted an unannounced annual inspection. LPA met with Director Noemi Jimenez and discussed the nature and purpose of the inspection. Together both director and LPA conducted a tour of the facility inside and outside. There was 0 children in care at the time of the inspection and 3 staff. The center operates from 8am to 3pm Monday-Friday. Center provides a half day morning and afternoon session.
Licensing required notices were posted prominently on the wall in the classroom. Facility uses one classroom. Bathrooms was observed to be clean and free of toxins. The outdoor playground is completely enclosed by a fence. The playground has age appropriate toys/equipment. LPA did not observe any toxins/hazardous items accessible to children. The classroom has age appropriate toys and furniture available for children. There is a functioning carbon monoxide detector that meets statutory requirement. LPA observed and reviewed the posted lunch menu. The center provides lunch as well as breakfast.

Center uses paper sign in sheet. A sampling of children and staff records were reviewed and found current. At least one Teacher present has current Pediatric First Aid/CPR certificates that expire on 12/30/2024. Teachers present have current AB 1207 Mandated Reporter Training certificates that expire on 08/21/2024. The last fire drill was conducted on 2/10/2023. Center is not currently providing Incidental Medical Services (IMS)



Continued on 809-C
SUPERVISOR'S NAME: Ana TolentinoTELEPHONE: (805) 562-0437
LICENSING EVALUATOR NAME: Rona ChavezTELEPHONE: (424) 299-1480
LICENSING EVALUATOR SIGNATURE:
DATE: 03/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/03/2023
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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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: VUSD - PORTOLA JUMPSTART STATE PRESCHOOL PROGRAM
FACILITY NUMBER: 566208287
VISIT DATE: 03/03/2023
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Director was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes 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.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee Noemi Jimenez .

SUPERVISOR'S NAME: Ana TolentinoTELEPHONE: (805) 562-0437
LICENSING EVALUATOR NAME: Rona ChavezTELEPHONE: (424) 299-1480
LICENSING EVALUATOR SIGNATURE:

DATE: 03/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2023
LIC809 (FAS) - (06/04)
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