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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566215701
Report Date: 05/17/2019
Date Signed: 11/04/2020 12:10:06 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:VENTURA RIVER CHILD DEVELOPMENT CENTERFACILITY NUMBER:
566215701
ADMINISTRATOR:SHERYL SHUSHANFACILITY TYPE:
830
ADDRESS:5301 N. VENTURA AVE. BLDG. 5TELEPHONE:
(970) 531-3134
CITY:VENTURASTATE: CAZIP CODE:
93001
CAPACITY:12CENSUS: DATE:
05/17/2019
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
10:45 AM
MET WITH:Jessica DerbyTIME COMPLETED:
12:45 PM
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 REPORT AMENDED
Licensing Program Analyst (LPA) Jill Laxo and Licensing Program Manager George Mingle made an unannounced visit to conduct a case management for increase in capacity for the infant program. LPA met with Jessica Derby, Program Manager and toured the infant facility inside and out. Needs and services plans were current for children present. Staff present have required immunization and qualifications needed to function in their role. CPR/First aid for staff was current and will expire on 11/17/2019. Children files reviewed had identification and emergency information, immunization records and notifications of parent's rights.

The new room #503 is connected to the licensed room #504. Fire clearance was granted by Ventura County Fire Department on 5/2/2019, for 24 children. Room toured has a separate crib area, washer and dryer with 3 sinks. Program Director stated a changing table will be located within an arms reach of sink. The new room has 3 cribs present at the sleep area. Playroom is separate from the sleeping area. There is drinking water available in the classroom and will be provided outside by water pitcher and cups. The outdoor is attached to the center and is completely enclosed by a fence with gates.
Program Manager stated that the new class will be opening around October 1, 2019. All required licensing forms will be posted. The center uses a computerized sign in and out system. CONTINUED 809-C
SUPERVISOR'S NAME: Ana TolentinoTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Jill M Hazelhofer-LaxoTELEPHONE: (805) 635-5097
LICENSING EVALUATOR SIGNATURE:

DATE: 11/03/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2020
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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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: VENTURA RIVER CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 566215701
VISIT DATE: 05/17/2019
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 REPORT AMENDED
Based on the overall evaluation of the center measurement indoor total for classroom 503 and 504 is 1423.70 and outdoor total 2183.40 meets the requirements for 24 children.

Director will send photos of the following:
  • a changing table
  • parent notification board
  • toys and learning materials

A Guide to Safe Sleep and Effects of Lead Exposure brochures were provided.
SUPERVISOR'S NAME: Ana TolentinoTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Jill M Hazelhofer-LaxoTELEPHONE: (805) 635-5097
LICENSING EVALUATOR SIGNATURE:

DATE: 11/03/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2020
LIC809 (FAS) - (06/04)
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