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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566215048
Report Date: 05/22/2019
Date Signed: 05/22/2019 11:24:36 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:SOMIS COMMUNITY PRESCHOOLFACILITY NUMBER:
566215048
ADMINISTRATOR:NELLUM LEWISFACILITY TYPE:
850
ADDRESS:3300 WEST STREETTELEPHONE:
(805) 844-6093
CITY:SOMISSTATE: CAZIP CODE:
93066
CAPACITY:46CENSUS: 33DATE:
05/22/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Nellum LewisTIME COMPLETED:
11:35 AM
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Licensing Program Analyst (LPA) Frank Pedroza made an unannounced visit for the purpose of conducting an Annual Random Inspection. LPA explained the purpose of the visit with Director Nellum Lewis and together we toured the facility inside and out. At the time of the inspection there was 33 children in care. The center operates from 7:00 AM to 6:00 PM, Monday thru Friday. The center follows the Pleasant Valley School District schedule. The facility does have a summer program. They will be closed from June 14, 2019 - July 1, 2019.

The center uses three classrooms for the children all separated by ages. The two year old classroom has their own restroom available in the classroom. The other two classrooms are escorted by teachers to the facility restrooms. Children's bedding for their sleeping pads are stored separately in each child's assigned storage bin. Children observed to be supervised by qualified staff. LPA did not observe any toxins/hazardous items accessible to children. LPA reviewed the posted snack menu. Children bring their lunch from home. The outdoor playground has age appropriate toys and equipment. The facility has two outdoor storage building in the outdoor playground fully secured preventing children from having access. School supplies and toys are stored in the storage container. The second storage container is used by the church. Continued on 809C
SUPERVISOR'S NAME: George MingleTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisco PedrozaTELEPHONE: (805) 689-4212
LICENSING EVALUATOR SIGNATURE:

DATE: 05/22/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2019
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: SOMIS COMMUNITY PRESCHOOL
FACILITY NUMBER: 566215048
VISIT DATE: 05/22/2019
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There is drinking water available both inside and outside for the children.

Center has written sign-in/sign-out sheets. A sampling of children and staff records were reviewed. Teachers have required qualification. Teachers present have current First Aid/CPR certificates that have an expiration date of 07/16/2020. LPA verified SB 792 Child Care Adult Immunization and Tuberculosis Requirements. AB 1207 Mandated Reporter Training certificates current and expire on 08/19/2020. Center was provided a guide of the Effects of Lead Exposure pamphlet.

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.



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) 562-0410
LICENSING EVALUATOR NAME: Francisco PedrozaTELEPHONE: (805) 689-4212
LICENSING EVALUATOR SIGNATURE:

DATE: 05/22/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2019
LIC809 (FAS) - (06/04)
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