<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566211800
Report Date: 06/06/2019
Date Signed: 06/06/2019 02:48:35 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:PACIFIC CAMPS OXNARDFACILITY NUMBER:
566211800
ADMINISTRATOR:ED HARLEYFACILITY TYPE:
840
ADDRESS:850 IVYWOOD DR.TELEPHONE:
(805) 983-0214
CITY:OXNARDSTATE: CAZIP CODE:
93030
CAPACITY:100CENSUS: 0DATE:
06/06/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
12:50 PM
MET WITH:Douglas EllisTIME COMPLETED:
03:00 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA) Francisco Pedroza made an unannounced visit to conduct an Annual/Random inspection. LPA met with Site Supervisor Douglas Ellis and explained the purpose of the visit. LPA and Site Supervisor toured the facility inside and out. At the time of the inspection, there was no children in care. Currently the center operates Monday - Friday from 12:00 pm to 6:00pm. The center will be changing their operating hours for their summer program. The hours will be Monday - Friday 6:00 am to 7:00 pm.

The facility uses two rooms for children in care and an outdoor recreation area. Each classroom has age appropriate toys and equipment. LPA did not observe any toxins/hazardous items accessible to children. LPA observed a posted snack menu that children have an opportunity to purchase from the center. The outdoor recreation area has sufficient amount of space available for child to enjoy activities. There is drinking water available both inside and outside for the children. Currently the facility does not have any children requiring incidental medical services (IMS).

Center has written sign-in/sign-out sheets. A sampling of children and staff records were reviewed. Continued on 809C
SUPERVISOR'S NAME: George MingleTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisco PedrozaTELEPHONE: (805) 689-4212
LICENSING EVALUATOR SIGNATURE:

DATE: 06/06/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/06/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 2
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: PACIFIC CAMPS OXNARD
FACILITY NUMBER: 566211800
VISIT DATE: 06/06/2019
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Teachers have required qualification. Teachers present have current First Aid/CPR certificates that expire on 05/01/2021. Teachers present have current Mandated Reporter (AB1207) certificates that expire on 03/23/2020. LPA verified SB 792 Child Care Adult Immunization and Tuberculosis Requirements. Center was provided a guide of the Effects of Lead Exposure pamphlet.

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

No deficiencies were cited during today's visit.



THE NOTICE OF SITE VISIT WAS POSTED AS REQUIRED BY H&S CODE SEC. 1596.817. THE NOTICE OF SITE VISIT MUST REMAIN POSTED FOR 30 DAYS OR A CIVIL PENALTY OF $100.00 WILL APPLY.
SUPERVISOR'S NAME: George MingleTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisco PedrozaTELEPHONE: (805) 689-4212
LICENSING EVALUATOR SIGNATURE:

DATE: 06/06/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/06/2019
LIC809 (FAS) - (06/04)
Page: 2 of 2