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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566213717
Report Date: 08/25/2021
Date Signed: 09/01/2021 11:57:15 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:CDR - SIERRA LINDA HEAD STARTFACILITY NUMBER:
566213717
ADMINISTRATOR:SUZANNE GODINEZFACILITY TYPE:
850
ADDRESS:2201 JASMINE STREETTELEPHONE:
(805) 485-9800
CITY:OXNARDSTATE: CAZIP CODE:
93036
CAPACITY:48CENSUS: 6DATE:
08/25/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Dina ElzahedTIME COMPLETED:
02:55 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
THIS IS AN AMENDED REPORT FROM THE ORIGINAL DATED 08/25/2021.
On August 25, 2021, at 1:30PM, Licensing Program Analyst (LPA) Betzayra Cervantes made an unannounced visit to conduct a Required - 1 Year inspection. LPA met with Site Supervisor Dina Elzahed and discussed the nature and purpose of the visit and together a tour of the facility was conducted both inside and outside. The center is located on the premises of Sierra Linda Elementary School. LPA observed a total of 6 children under the care and supervision of 7 teachers including the Site Supervisor. The center currently operates from August to June from 8:00AM to 2:00 PM Monday through Friday.

The center has a total of two classrooms, "G" and "F" which were observed free of hazards and are equipped with age appropriate toys, teaching materials, and furnishings for children in care. The bathrooms were observed to be clean and sanitary. Waste containers have tight-fitting covers. There is drinking water readily available for children inside and outside the classrooms. The facility provides breakfast, lunch and snack for children in care. Menus were posted along with the site's facility license and Emergency Disaster Plan. The playground is fenced with appropriate shading and was observed in good condition and free of hazards. The areas around or under high climbing equipment have cushioned material. No bodies of water were observed on the premises.

Sign in/out sheets were reviewed and found complete. All staff have a criminal record clearance. Staff records are located at the CDR Human Resource Office and will be reviewed at a later date. A sampling of children records were reviewed and LPA observed Admissions Agreement and Identification and Emergency Notification forms on file. CPR and First Aid cards are current with an expiration date of 1/30/2023.
Continued on 809-C
SUPERVISOR'S NAME: George MingleTELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Betzayra CervantesTELEPHONE: (805) 680-7175
LICENSING EVALUATOR SIGNATURE:

DATE: 08/25/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/25/2021
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: CDR - SIERRA LINDA HEAD START
FACILITY NUMBER: 566213717
VISIT DATE: 08/25/2021
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
AB 1207 Mandated Reporter training certificate is current with an expiration date of 08/12/2023.

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. Exit interview and a copy of this report was reviewed and provided to the Site Supervisor.



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: 08/25/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/25/2021
LIC809 (FAS) - (06/04)
Page: 2 of 2