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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566203831
Report Date: 01/07/2025
Date Signed: 01/07/2025 03:05:32 PM

Document Has Been Signed on 01/07/2025 03:05 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:VENTURA BRANCH - ELMHURST ELEMENTARYFACILITY NUMBER:
566203831
ADMINISTRATOR/
DIRECTOR:
JENNIFER HEUNEN-STIFFLERFACILITY TYPE:
840
ADDRESS:5080 ELMHURST ST.TELEPHONE:
(805) 256-2474
CITY:VENTURASTATE: CAZIP CODE:
93003
CAPACITY: 48TOTAL ENROLLED CHILDREN: 48CENSUS: 18DATE:
01/07/2025
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:10 PM
MET WITH:TIME VISIT/
INSPECTION COMPLETED:
03:10 PM
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On 1/7/2025,Licensing Program Analysts (LPA) German Negrete conducted an unannounced Annual/required inspection of the above mentioned Child Care -After School Program (Center). LPA met with Director Julianna Garibay. LPA explained the purpose and nature of the inspection. The after school program operates Monday – Friday 12PM to 6PM. At the time of inspection, LPA observed 18 children and 2 staff providing care and supervision.

LPA observed required licensing forms and documents posted near the main door entry. A menu is also posted in a visible location. The Center's children Sign In/Out forms were reviewed by LPA. The forms contained the arrival and departure times of children in care and well as the signatures of the children's authorized representatives(electronic). The one classroom was observed to be clean and orderly. The classroom has age-appropriate equipment and furnishings available to children in care. The Centers has a carbon monoxide detectors and additional smoke detectors. LPA tested Carbon Monoxide detector at 12:45PM. However smoke detectors could not be tested due to the alarms being connected to one system.



The Center uses two restrooms for children in care. All restrooms are in sanitary condition. However children in care are monitored by Center staff when using the restrooms. LPA observed a operable refrigerator in the classroom. If required, the refrigerator is used for food. Incidental medicine is stored in the staff closet inside a locked box(key is needed to open box). The Center provides snacks to children once a day. Lunch is not provided to children in care at this Center. The Center also has available filtered drinking water for children inside the facility. Child care center's constructed before 1/1/20, need to test their water (used for drinking and food preparation) for lead contamination before 1/1/23, and then every 5-years except after the date of the first test. For child care center licenses issued after 7/1/22, the licensee shall test their water for (Continued on LIC809-C)
SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: German Negrete
LICENSING EVALUATOR SIGNATURE: DATE: 01/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/07/2025
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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: VENTURA BRANCH - ELMHURST ELEMENTARY
FACILITY NUMBER: 566203831
VISIT DATE: 01/07/2025
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lead within 180 days of censure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP), LPA could not verify that lead testing was conducted by the CCC, in the appropriate time frame as outlined in Title 22.

Disinfectants, cleaning solutions and sharps are observed in locations(locked closet) accessible to staff members but accessible to children in care.

The Center outdoor playground areas is not enclosed by fencing(see advisory note). The surfaces of the outdoor playground areas utilizes concrete. LPA observed age appropriate play equipment in the play areas. The play equipment is free of sharp, loose or pointed objects. The play structures in the outdoor playground areas have adequate cushioning materials to absorb falls. No bodies of water are observed on site.

A sampling of staff and children records were reviewed. The children’s records were complete and found to contain emergency contact information, among other required licensing documentation(see LIC857) . Staff records were reviewed. LPA reviewed Mandated Reporter training certifications for staff and found Mandated Reporter Training certification is up to date. Director was reminded to ensure training certification are kept current. Director notes no firearms or ammunition are stored on site.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of “medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication. Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

Center representative was reminded that all adults 18 and over, including employees and volunteers,
as specified in HSC section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated. (CONT. LIC809-C)
SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: German Negrete
LICENSING EVALUATOR SIGNATURE:

DATE: 01/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/07/2025
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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: VENTURA BRANCH - ELMHURST ELEMENTARY
FACILITY NUMBER: 566203831
VISIT DATE: 01/07/2025
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Director was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

A notice of site visit was given and must remain posted for 30 days. A advisory note was issued, and a technical violation was issued. Exit interview conducted and report was reviewed with Director.
SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: German Negrete
LICENSING EVALUATOR SIGNATURE:

DATE: 01/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/07/2025
LIC809 (FAS) - (06/04)
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