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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566215284
Report Date: 10/01/2019
Date Signed: 10/01/2019 03:26:59 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:FUSD-MOUNTAIN VISTA PRE SCHOOLFACILITY NUMBER:
566215284
ADMINISTRATOR:HOLLY HARVANFACILITY TYPE:
850
ADDRESS:918 FIFTH STREETTELEPHONE:
(805) 524-6781
CITY:FILLMORESTATE: CAZIP CODE:
93015
CAPACITY:24CENSUS: 11DATE:
10/01/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Holly HarvanTIME COMPLETED:
03:45 PM
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Licensing Program Analyst(LPA), Laura Villanueva made an unannounced inspection in order to conduct an Annual/random review and met with the Director, Holly Harvan. The purpose of the visit was discussed and a tour of the facility was conducted.

The classroom was found clean, organized with age appropriate equipment The restroom was found clean and free of toxins. There is a functioning carbon monoxide detector that meets statutory requirement. All required State forms were posted. Menu was posted.

The outdoor play area is completely fenced with shade and grass areas. Drinking water is available inside and outside.
Teacher files reviewed and were found complete with State required forms. Teacher is current with CPR and First Aid which expires 8/7/21. Children's files reviewed and found complete.

The center is currently not providing Incidental Medical Services. 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

In areas evaluated, no deficiencies. Notice of site visit was given.
SUPERVISOR'S NAME: George MingleTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Laura VillanuevaTELEPHONE: (805) 722-5138
LICENSING EVALUATOR SIGNATURE:

DATE: 10/01/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/01/2019
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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