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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566210701
Report Date: 11/20/2024
Date Signed: 11/20/2024 02:30:15 PM

Document Has Been Signed on 11/20/2024 02:30 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:CORNERSTONE CHRISTIAN PRESCHOOLFACILITY NUMBER:
566210701
ADMINISTRATOR/
DIRECTOR:
ELIZABETH LUNDBERGFACILITY TYPE:
850
ADDRESS:1777 ARNEILL ROADTELEPHONE:
(805) 987-7108
CITY:CAMARILLOSTATE: CAZIP CODE:
93010
CAPACITY: 88TOTAL ENROLLED CHILDREN: 88CENSUS: 46DATE:
11/20/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:45 AM
MET WITH:Elizabeth LundbergTIME VISIT/
INSPECTION COMPLETED:
01:15 PM
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On November 20, 2024 at 11:45 AM, Licensing Program Analyst (LPA) Aaliyah Zendejas made an unannounced visit for the purpose of conducting a Case Management - Incident inspection. LPAs met with Director Elizabeth Lundberg to discuss an incident that was self reported to Community Care Licensing Division (CCLD) office by phone on 09/23/2024. LPA toured the play yard area where the incident occurred and interviewed the Director, and staff that were involved in the incident.

On 09/19/2024 an incident occurred at the center at about 11:15 AM. C1 was running from the wood chip area of the play yard to the grass area and tripped. C1 fell on their hands and knees and then had a medical episode that was believed to be a seizure. S1 stated that C1 fell on their hands and knees, began to cry, their eyes rolled back, they arched their back and had a medical episode. S1 stated that the episode was very brief. Staff then contacted emergency services about 5 minutes after the incident due to the child being pale, and being very weak and quiet after the incident occurred. C1 was then taken to the hospital.

The child returned to the facility the next day. Parents of C1 have told staff that incidents like these have occurred previously. To prevent any similar incidents, staff has been instructed to remind children to walk and not run within the play area, and to keep a watchful eye of the children playing in case of any similar situation were to occur.

Given the incident was observed by staff who took appropriate action by reporting to licensing, calling emergency services, and this being an incident that could not have been prevented by staff, no deficiencies are being cited today.

A Notice of Site Visit (LIC 9213) was given and must remain posted for 30 days.
Appeal Rights were provided to Director Elizabeth Lundberg
Exit interview conducted and report was reviewed with the Director Elizabeth Lundberg.
SUPERVISORS NAME: Lissete Gonzalez
LICENSING EVALUATOR NAME: Aaliyah Zendejas
LICENSING EVALUATOR SIGNATURE: DATE: 11/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/20/2024
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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