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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566214919
Report Date: 12/03/2021
Date Signed: 12/03/2021 03:00:59 PM

Document Has Been Signed on 12/03/2021 03:00 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:VUSD - PACIFIC HIGH JUMPSTART STATE PRESCHOOLFACILITY NUMBER:
566214919
ADMINISTRATOR:LORETTA GALAVIZFACILITY TYPE:
850
ADDRESS:501 COLLEGE DRIVETELEPHONE:
(805) 641-5000
CITY:VENTURASTATE: CAZIP CODE:
93003
CAPACITY: 16TOTAL ENROLLED CHILDREN: 16CENSUS: 0DATE:
12/03/2021
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
02:20 PM
MET WITH:Andrea VoglTIME COMPLETED:
03:10 PM
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At 2:20 PM, a case management inspection was conducted by Licensing Program Analyst (LPA) S. Mendoza-Ceja to follow up on the increase of capacity from 16 children to 28 children. The preschool would like to operate in two classrooms #4 and #5. The classrooms #4 and #5 were observed to be clean, orderly and appropriately furnished indoors and outdoors for young children.

In regards to the increase of capacity LPA S. Mendoza-Ceja re-evaluated the program which now meets the requirement for 28 children. Loretta Galaviz, Coordinator Early Childhood Education, was able to obtain approval to change restrooms with another program.

Indoor square feet exceeds the requirement needs for 28 preschoolers.
Outdoor square footage exceeds the requirement for 28 preschoolers.
Two toilets and two sinks exceeds the requirement for 28 preschoolers.
Water is available indoor and outdoors.
Shade was observed to be available.

Based on the above evaluation of the program, the center meets the requirement for 28 children.

Fire Clearance was granted on 09/08/2021. Licensure effective 12/03/2021.
Ana Tolentino
Sylvia Mendoza-Ceja
DATE: 12/03/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/03/2021
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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