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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566213545
Report Date: 10/11/2019
Date Signed: 10/11/2019 11:20:06 AM

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:SAKURA JAPANESE DAYCAREFACILITY NUMBER:
566213545
ADMINISTRATOR:TSUNEKO EVANSFACILITY TYPE:
850
ADDRESS:1800 SOUTH C ST. RM 15 & 16TELEPHONE:
(805) 201-5886
CITY:OXNARDSTATE: CAZIP CODE:
93033
CAPACITY:15CENSUS: 12DATE:
10/11/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
10:25 AM
MET WITH:Tsuneko EvansTIME COMPLETED:
11:35 AM
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 Analysts (LPA's) Betzayra Cervantes and Michael Avila made an unannounced visit for the purpose of conducting an Annual Random visit. The purpose of the visit was discussed with the Licensee Tsuneko Evans. A tour of the facility was conducted together with both LPA's and Licensee. The facility is located on the property of St. Paul's Church. Classroom 15 & 16 are utilized for care of the children. No toxins nor hazards were observed accessible to children in care. The classrooms have age appropriate toys and furniture. The restroom located in between Classroom 15 & 16 was observed clean and sanitary. LPA's observed a posted menu and required licensing forms and sign in and out sheets were reviewed and found to be in compliance.

Facility does not have a kitchen, children bring their lunch and facility provides a morning and afternoon snack. Outdoor play area is shared with another preschool on the premises but children are not commingled. Outside play equipment is in safe condition and in good repair. There is sufficient sand around and under play climbing equipment. For drinking water, parents are encourage to bring a bottle of water for children in care, however, the facility has water accessible to children via a water fountain and bottle water.

A sample of children's files were reviewed and found to be complete. Licensee's CPR/First-Aid is current until 08/25/2021. Last emergency drill was conducted on 10/02/2019. LPA's discussed AB1207 Mandated Reporter Training and reminded Licensee it is her responsibility to be aware of all child care regulations which can be accessed at www.ccld.ca.gov.

Continued on 809-C
SUPERVISOR'S NAME: George MingleTELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Betzayra CervantesTELEPHONE: (805) 680-7175
LICENSING EVALUATOR SIGNATURE:

DATE: 10/11/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2019
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: SAKURA JAPANESE DAYCARE
FACILITY NUMBER: 566213545
VISIT DATE: 10/11/2019
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
Incidental Medical Services (IMS) policy was discussed with Licensee and is currently cot caring for children with IMS. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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) 562-0411
LICENSING EVALUATOR NAME: Betzayra CervantesTELEPHONE: (805) 680-7175
LICENSING EVALUATOR SIGNATURE:

DATE: 10/11/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2019
LIC809 (FAS) - (06/04)
Page: 2 of 2