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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566215900
Report Date: 10/08/2021
Date Signed: 10/08/2021 01:41:06 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:TRINITY LUTHERAN PRESCHOOLFACILITY NUMBER:
566215900
ADMINISTRATOR:LAUNER KERRIFACILITY TYPE:
830
ADDRESS:2949 ALAMO STREETTELEPHONE:
(805) 526-5975
CITY:SIMI VALLEYSTATE: CAZIP CODE:
93063
CAPACITY:10CENSUS: 10DATE:
10/08/2021
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
12:41 PM
MET WITH:Kerri LaunerTIME COMPLETED:
01:55 PM
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On October 8, 2021 at 12:41 AM, Licensing Program Analyst (LPA) Francisco Pedroza conducted an unannounced Case Management inspection. LPA met with facility Director Kerri Launer and advised the purpose of the inspection. Director Provided LPA a tour of the facility inside and out. There were 10 children in care at the time of the inspection. The center operates from 7:00 AM to 6:00 PM, Monday thru Friday. This is a combined center with an preschool component.

On July 19, 2021 licensee submitted an application to Community Care Licensing (CCL) for an increase in capacity. CCL requested a fire clearance inspection from Ventura County Fire Department (VCFD) on July 19, 2021. On August 4, 2021, CCL received an approved fire clearance from VCFD. Facility submitted a waiver request for their outdoor recreation yard. The waiver was approved on August 11, 2021. Facility is required to follow the waiver requirements at all times. The waiver can be voided by Community Care Licensing at any time should the facility not follow the requirements. The waiver must be posted in view at all times. LPA conducted the annual inspection for the facility prior to conducting the increase inspection with no deficiencies cited.

Effective today October 8, 2021 facility increase in capacity is approved with a maximum capacity of 12 infants.

THE NOTICE OF SITE VISIT WAS POSTED AS REQUIRED BY H&S CODE SEC. 1596.817
SUPERVISOR'S NAME: George MingleTELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Francisco PedrozaTELEPHONE: (805) 689-4212
LICENSING EVALUATOR SIGNATURE:

DATE: 10/08/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/08/2021
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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