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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566209597
Report Date: 09/10/2019
Date Signed: 09/10/2019 03:19:16 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:CDR - JULIE IRVING HEAD START CENTERFACILITY NUMBER:
566209597
ADMINISTRATOR:SUZANNE GODINEZFACILITY TYPE:
850
ADDRESS:231 VENTURA BLVD.TELEPHONE:
(805) 485-7878
CITY:OXNARDSTATE: CAZIP CODE:
93036
CAPACITY:48CENSUS: 47DATE:
09/10/2019
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Megan RamseyTIME COMPLETED:
12:00 PM
NARRATIVE
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Licensing Program Analyst (LPA) Michael Avila made an unannounced visit for the purpose of conducting a Case Management inspection. LPA Avila met with Site Supervisor Megan Ramsey and discussed the nature and purpose of the visit.

Licensee self-reported an incident that occurred on the first day of the preschool where on 8/26/2019, a child (C1) was discovered to have left the classroom without supervision. The incident occurred at/or around 2pm when children were getting ready to be picked up at the facility. The child who was newly enrolled in the preschool left with a group of other children accompanied by an adult. Staff (S2, S3, S4 & S5), who were preoccupied with other parents picking up their own children, did not realize the child had walked out of the classroom into the hallway of the center. The hallway led down to an entrance door to the building. A staff teacher (S1) who was just outside the entrance door observed the child (C1) and escorted the child back into the classroom. LPA determined the child was only momentarily out of visual supervision of the teachers from the time he went from the classroom to the exit door of the building.

Although the child was momentarily without supervision, there were sufficient staff present at the time to prevent the child from leaving the building. LPA deemed there was not an immediate threat but rather a potential harm to the health and safety of the child had there not been a staff teacher at the exit of the building to prevent the child from leaving the facility unattended.

Based on the information obtained, the facility is being cited a type "B" deficiency for the following C.C.R., Div. 12, Title 22 regulation: 101229(a)(1) - Responsibility for providing Care and Supervision.

Licensee was provided with a copy of appeal rights.
SUPERVISOR'S NAME: George MingleTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Michael AvilaTELEPHONE: (805) 722-5133
LICENSING EVALUATOR SIGNATURE:

DATE: 09/10/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2019
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: CDR - JULIE IRVING HEAD START CENTER
FACILITY NUMBER: 566209597
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/10/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/10/2019
Section Cited

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Responsibility for Providing Care and Supervision. states: The licensee shall provide care and supervision as necessary to meet the children's needs. (1) No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1) Supervision shall include visual observation.
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This regulation was not met as evident on 8/26/19 a child (C1) was discovered to have left the classroom unknowingly by staff and discovered by another staff member as he attempted to exit the building. This posed a potential risk of harm to the heath and safety of children in care
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: George MingleTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Michael AvilaTELEPHONE: (805) 722-5133
LICENSING EVALUATOR SIGNATURE:
DATE: 09/10/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/10/2019
LIC809 (FAS) - (06/04)
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