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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566213560
Report Date: 02/22/2022
Date Signed: 02/22/2022 03:21:04 PM


Document Has Been Signed on 02/22/2022 03:21 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:FREDRICKSON FAMILY EARLY CHILDHOOD CENTERFACILITY NUMBER:
566213560
ADMINISTRATOR:KATHRYN DEANFACILITY TYPE:
830
ADDRESS:3450 CAMPUS DR.TELEPHONE:
(805) 493-3247
CITY:THOUSAND OAKSSTATE: CAZIP CODE:
91360
CAPACITY:6CENSUS: 5DATE:
02/22/2022
TYPE OF VISIT:Case Management - COVID-19UNANNOUNCEDTIME BEGAN:
12:55 PM
MET WITH:Yvanna HerreraTIME COMPLETED:
01:35 PM
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On February 22, 2022 at 12:56 PM, Licensing Program Analysts (LPA) Dean Thompson and Licensing Program Manager (LPM) George Mingle conducted an unannounced Case Management – COVID-19 inspection and met with, representative Yvanna Herrera. LPA informed the purpose for the inspection and completed a COVID-19 pre-screening questions prior to the commencement of the inspection. Representative gave LPA a tour of the facility, inside and outside.

This inspection is a follow-up on COVID-19 outbreaks reported by facility staff to CCL between January 19, 2022 - February 15, 2022. Representative stated, there has not been any other positive cases reported since the last outbreak on February 15th, 2022. A Rapid Assistance Support (RAST) call was placed on July 3, 2020. Facility was closed during the time of the call and reopened august 17, 2020. LPA provided facility with a Covid 19 Child Care Program Self-Assessment Guide form which needs to be complete and submitted by March 8, 2021 to LPA via email or text. LPA observed staff wearing masks upon arrival to the facility. Children in care also had masks on during this inspection. Before entering the facility covid pre-screening questions were asked, sanitizer is available outside and throughout the facility, safety posters were posted, and temperature check were conducted.

Continued on 809-C
SUPERVISOR'S NAME: George MingleTELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Dean ThompsonTELEPHONE: (805) 729-8797
LICENSING EVALUATOR SIGNATURE:
DATE: 02/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/22/2022
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: FREDRICKSON FAMILY EARLY CHILDHOOD CENTER
FACILITY NUMBER: 566213560
VISIT DATE: 02/22/2022
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LPA was given the facility’s written plan for when a staff member or child tests positive for COVID-19 and viewed a written communication plan with parents/guardians to share information and guidelines in their preferred language. LPA discussed COVID-19 Vaccines, Testing, Face coverings, Essential Protective Equipment and Supplies, Physical Distancing, Ventilation, Isolation for Illness, Cleaning and Disinfection, Handwashing, Food Service and Mealtimes, How to Respond to Exposures or Outbreaks, and Resilience Tips during the Pandemic.

LPA provided the following resources:
- Official Public Health and Child Care Guidance for COVID-19 – Updated 1/26/2022.
- COVID-19 Child Care Resources:
https://www.cdss.ca.gov/inforesources/cdss-programs/community-care-licensing/child-care-licensing/covid-19-child-care-resources

There were no deficiencies cited during today's inspection.

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

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.


Exit interview conducted and report was reviewed with the representative Yvanna Herrera.
SUPERVISOR'S NAME: George MingleTELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Dean ThompsonTELEPHONE: (805) 729-8797
LICENSING EVALUATOR SIGNATURE:

DATE: 02/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/22/2022
LIC809 (FAS) - (06/04)
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