566215756-5-25-2022-17-CC-DTHN-CERLW4-20220525090631

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 566215756
Report Date: 05/25/2022
Date Signed: 05/25/2022 09:06:35 AM

Document Has Been Signed on 05/25/2022 09:06 AM - 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:	CAMP AMGEN		FACILITY NUMBER:	566215756
ADMINISTRATOR:	JENNIFER MCHUGH		FACILITY TYPE:	840
ADDRESS:	855 NORTH VENTU ROAD		TELEPHONE:	(805) 447-6793
CITY:	THOUSAND OAKS	STATE: CA	ZIP CODE:	91320
CAPACITY:	40	CENSUS:	DATE:	05/25/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:15 AM
MET WITH:	Jennifer Martinez		TIME COMPLETED:	09:24 AM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On May 25, 2022 at 8:23 AM, Licensing Program Analyst (LPA) Dean Thompson conducted an unannounced Annual/Random inspection. LPA met with Program Director Jennifer Martinez and advised her the purpose of the inspection. Director provided LPA a tour of the facility inside and out. There were no teachers in the classroom or children in care at the time of the inspection. Currently the school age program is closed and the center plans to reopen on June 13, 2022. The facility operating hours are from 7:30 AM to 5:30 PM, Monday through Friday. This is a combined center with a Preschool and Infant programs. Licensing required documents were posted prominently on the wall at the entrance of the facility. The facility uses two classrooms for the school age program. Children are escorted to staff resource room 1418 for restroom breaks. LPA did not observe any toxins/hazardous items that would be accessible to children when in care. The classrooms have age appropriate toys and furniture available. First Aid kits were observed inside the classroom near the exit door. Facility provides morning and afternoon snacks. Children have the option to order lunch from the center or bring a lunch from home. Center uses written sign-in/sign-out sheets located at the entrance of each classroom. The outdoor playground is shaded and has an ample amount of space for children to play. LPA observed the playground has age-appropriate toys and structures available for children to use. Continued on LIC 809-C

SUPERVISOR'S NAME: George Mingle	TELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Dean Thompson	TELEPHONE: (805) 729-8797
LICENSING EVALUATOR SIGNATURE:	DATE: 05/25/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/25/2022

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: CAMP AMGEN	FACILITY NUMBER: 566215756
	VISIT DATE: 05/25/2022

NARRATIVE

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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

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

Director was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

No deficiencies were cited.

A notice of site visit was given and must remain posted for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with Director Jennifer Martinez.

SUPERVISOR'S NAME: George Mingle	TELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Dean Thompson	TELEPHONE: (805) 729-8797
LICENSING EVALUATOR SIGNATURE:	DATE: 05/25/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/25/2022

LIC809 (FAS) - (06/04)

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