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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566215006
Report Date: 11/07/2019
Date Signed: 11/07/2019 01:36:42 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:PARKIN FAMILY CHILD CAREFACILITY NUMBER:
566215006
ADMINISTRATOR:KIMBERLY PARKINFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 672-1891
CITY:VENTURASTATE: CAZIP CODE:
93003
CAPACITY:14CENSUS: 9DATE:
11/07/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Kimberly ParkinTIME COMPLETED:
01:30 PM
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Licensing Program Analyst Michael Avila made an unannounced visit for the purpose conducting an Case Management Inspection. LPA Avila met with Licensee Kimberly Parkin and discussed the nature and purpose of the visit. LPA Avila advised Licensee efforts were made by the Department to contact Licensee via phone regarding the Maria and Easy Fires near Licensee's location but could not reach Licensee. LPA obtained additional contact information from Licensee to communicate with her facility in case of an emergency. LPA Avila discussed Disaster Planning Preparation with Licensee and the need to ensure to keep in communication with the Department whenever there is an emergency disaster incident in her area.

No deficiencies were issued during this unannounced visit.
SUPERVISOR'S NAME: George MingleTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Michael AvilaTELEPHONE: (805) 722-5133
LICENSING EVALUATOR SIGNATURE:

DATE: 11/07/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2019
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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