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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566214257
Report Date: 03/04/2020
Date Signed: 03/04/2020 01:27:24 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 - JUANAMARIAFACILITY NUMBER:
566214257
ADMINISTRATOR:RACHEL CHAMPAGNEFACILITY TYPE:
850
ADDRESS:100 CROCKER AVENUETELEPHONE:
(805) 647-7948
CITY:VENTURASTATE: CAZIP CODE:
93004
CAPACITY:25CENSUS: 13DATE:
03/04/2020
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
12:35 PM
MET WITH:Robin O TooleTIME COMPLETED:
01:35 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) Christian Patterson and Austin Rios made an unannounced inspection to the facility for the purpose of conducting a REQUIRED 1-YEAR inspection. LPA met with Director Robin O Toole and explained the purpose of the inspection. The facility operates Monday- Friday from 7am-6pm. There were 13 children present. A tour of the facility was made both inside and outside. The classrooms were observed to have age appropriate furniture/equipment. The restrooms were observed to be clean and free of toxins. There is a functioning smoke/carbon monoxide detector in each classroom. All required State forms and daily menu were posted. The outdoor play area is completely fenced. LPA observed age appropriate equipment. Drinking water is available inside and outside.

Teacher files reviewed and were found to be complete. Teacher's Medical Health Records were verified. At least one teacher in each classroom has valid Pediatric CPR/First Aid which expires on 11/08/21. Center staff have completed AB1207 Mandated Reporter Training. Sign in and sign out verified and matched census. Children's files were reviewed and found to be complete. Regulation fire extinguisher was serviced on 08/27/2020.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.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
SUPERVISOR'S NAME: Ana TolentinoTELEPHONE: (805) 562-0347
LICENSING EVALUATOR NAME: Christian PattersonTELEPHONE: (805) 315-8362
LICENSING EVALUATOR SIGNATURE:

DATE: 03/04/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2020
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: CDI - JUANAMARIA
FACILITY NUMBER: 566214257
VISIT DATE: 03/04/2020
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
Director is reminded that they are responsible for knowing the regulations for a Child Care Center and that Licensing information can be accessed online at www.ccld.ca.gov. LPA reviewed and provided Director with Infant Safe Sleep and Effects of Lead Exposure Brochures


There were no deficiencies cited today. The LIC 9213 (Notice of Site Visit) was posted in LPA's presence.
SUPERVISOR'S NAME: Ana TolentinoTELEPHONE: (805) 562-0347
LICENSING EVALUATOR NAME: Christian PattersonTELEPHONE: (805) 315-8362
LICENSING EVALUATOR SIGNATURE:

DATE: 03/04/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2020
LIC809 (FAS) - (06/04)
Page: 2 of 2