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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566212783
Report Date: 09/25/2019
Date Signed: 09/25/2019 01:00:36 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:CDI - DEL NORTE CHILD DEVELOPMENT CENTERFACILITY NUMBER:
566212783
ADMINISTRATOR:RACHEL CHAMPAGNEFACILITY TYPE:
850
ADDRESS:2500 LOBELIA DR.TELEPHONE:
(805) 988-3983
CITY:OXNARDSTATE: CAZIP CODE:
93036
CAPACITY:72CENSUS: 44DATE:
09/25/2019
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
12:21 PM
MET WITH:Jennifer EscamillaTIME COMPLETED:
01:15 PM
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Licensing Program Analysts (LPAs) Betzayra Cervantes and Francisco Pedroza made an unannounced visit to conduct a Case Management - Incident inspection. LPA's met with Site Supervisor Jennifer Escamilla and advised her the purpose of the inspection. LPAs and Site Supervisor together toured the facility inside and out. There was 44 children in care at the time of the inspection.

The facility self reported an incident that occurred on 09/19/2019 regarding possible suspected child abuse. According to T1, P1 requested to speak to her on 09/18/2019 at approximately 7:35 AM regarding their daughter and expressed concerns regarding the P2 and the treatment of the child. P1 stated that she found bruises on C1's body and took pictures for documentation. Center staff cross reported the incident to Child Protective Services and Community Care Licensing (CCL). C1's file was reviewed and center staff was interviewed. A social worker from Child Protective Services interviewed C1 at the facility and released her to P2.

Child #1 is currently attending the center and no new incidents have occurred. Center has taken the proper steps as Mandated Reports and to protect the safety of the child, the center also informed the parents, and reported to the Licensing Office of the unusual incident as required.

There were no deficiencies cited today.
SUPERVISOR'S NAME: George MingleTELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Betzayra CervantesTELEPHONE: (805) 680-7175
LICENSING EVALUATOR SIGNATURE:

DATE: 09/25/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2019
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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