566215790-6-11-2021-17-CC-FPEA-C3VQZW-20210611123724

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 566215790
Report Date: 06/11/2021
Date Signed: 06/11/2021 12:37:32 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:	CVUSD PRESCHOOL AT UNIVERSITY		FACILITY NUMBER:	566215790
ADMINISTRATOR:	AMIE MILLS		FACILITY TYPE:	850
ADDRESS:	2801 ATLAS AVENUE		TELEPHONE:	(805) 497-9511
CITY:	THOUSAND OAKS	STATE: CA	ZIP CODE:	91360
CAPACITY:	24	CENSUS: 0	DATE:	06/11/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:29 AM
MET WITH:	Amie Mills		TIME COMPLETED:	12:00 PM

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 June 10, 2021 at 11:34 AM, Licensing Program Analysts (LPAs) Francisco Pedroza and Austin Rios conducted an unannounced annual random inspection. LPAs met with facility Director Amie Mills and explained the purpose of the inspection. Director provided LPAs a tour of the facility inside and out. There were no children in care at the time of the inspection. The facility has closed for Summer vacation. The center operates from 8:45 AM to 3:45 PM, Monday thru Friday. LPAs observed required licensing documents posted. The preschool uses one classroom for care. LPAs did not observe any toxins/hazardous items accessible to children. The classrooms have age appropriate toys and furniture available for children. There was no posted snack menu since the facility closed. During normal operations, the children are provided one snack. The outdoor playground has age appropriate toys and equipment. The playground has an ample amount of shade available. The center has water available for children inside and out. Center uses written sign-in/sign-out sheets. There were no samplings of children records to review. Staff records are located at another location. Continued on 809C.

SUPERVISOR'S NAME: George Mingle	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisco Pedroza	TELEPHONE: (805) 689-4212
LICENSING EVALUATOR SIGNATURE:	DATE: 06/11/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/11/2021

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: CVUSD PRESCHOOL AT UNIVERSITY	FACILITY NUMBER: 566215790
	VISIT DATE: 06/11/2021

NARRATIVE

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LPAs will review the records at a later date. Teachers present have current First Aid/CPR certificates that expire on 3/17/2023. Teachers present have current AB 1207 Mandated Reporter Training certificates that expire on 8/25/2022. LPAs verified SB 792 Child Care Adult Immunization and Tuberculosis Requirements. LPAs advised Director about the recent Lead requirements.

Incidental Medical Services (IMS) policy was discussed and currently the center does have children with IMS. Plan of Operations on file. 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 Mingle	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisco Pedroza	TELEPHONE: (805) 689-4212
LICENSING EVALUATOR SIGNATURE:	DATE: 06/11/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/11/2021

LIC809 (FAS) - (06/04)

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