566215810-8-9-2019-17-CC-JMHL-BEVU7L-20190809152008

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 566215810
Report Date: 08/09/2019
Date Signed: 08/09/2019 03:20:23 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:	DWIGHT FCC AKA MEADOWS MONTESSORI OJAI		FACILITY NUMBER:	566215810
ADMINISTRATOR:	KATHRYN JUNIPER DWIGHT		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(805) 637-7506
CITY:	OJAI	STATE: CA	ZIP CODE:	93023
CAPACITY:	14	CENSUS: 0	DATE:	08/09/2019
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Kathryn Juniper Dwight		TIME COMPLETED:	03:30 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	Licensing Program Analyst (LPA) Jill Laxo made an announced inspection to facility for the purpose of Pre-licensing. The FCCH location was previously licensed #566213730 with licensee Martha Zavala Esquer. A tour of the home was conducted inside and out by LPA, Licensee and landlord Martha Esquer. This home is a one story and has a separate entrance for classrooms that will be used for the day care program. The facility will operate in two rooms including an attached bathroom. The dwelling (living area) is off limits with locked doors and inaccessible to children in care. Outdoor space is gated and fenced. The backyard will be used for activities and has age appropriate equipment. There are no bodies of water and licensee stated no guns, weapons or ammunition on premises. All toxins and sharp items are located in the dwelling and inaccessible to the children. Licensee stated liability insurance is up to date. Control of property was verified via signed rental agreement. Licensee provided complete immunization records. Licensee's CPR / First Aid is current with an expiration date of 06/2021. Fire extinguisher last serviced on 08/08/2019. LPA verified Licensee has all required documents posted. AB1207 expires 07/09/2021. LPA verified Health training certificate, orientation certificate and LIC 610 Emergency Disaster Plan were completed.

SUPERVISOR'S NAME: George Mingle	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Jill M Hazelhofer-Laxo	TELEPHONE: (805) 635-5097
LICENSING EVALUATOR SIGNATURE:	DATE: 08/09/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2019

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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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: DWIGHT FCC AKA MEADOWS MONTESSORI OJAI	FACILITY NUMBER: 566215810
	VISIT DATE: 08/09/2019

NARRATIVE

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Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing 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 http://www.ada.gov/childqanda.htm

The home meets the requirements of large Family Child Care Home.

SUPERVISOR'S NAME: George Mingle	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Jill M Hazelhofer-Laxo	TELEPHONE: (805) 635-5097
LICENSING EVALUATOR SIGNATURE:	DATE: 08/09/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2019

LIC809 (FAS) - (06/04)

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