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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566215196
Report Date: 07/23/2021
Date Signed: 07/23/2021 11:59:56 AM

Document Has Been Signed on 07/23/2021 11:59 AM - It Cannot Be Edited

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:PHOENIX RANCH SCHOOL & CAMP (WEST CAMPUS)FACILITY NUMBER:
566215196
ADMINISTRATOR:VICTORIA DE LEONFACILITY TYPE:
850
ADDRESS:4974 COCHRAN AVE.TELEPHONE:
(805) 527-7764
CITY:SIMI VALLEYSTATE: CAZIP CODE:
93063
CAPACITY: 197TOTAL ENROLLED CHILDREN: 0CENSUS: 67DATE:
07/23/2021
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Victoria De LeonTIME COMPLETED:
12:10 PM
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On July 23, 2021 at 9:21 am, Licensing Program Analysts (LPA's) Francisco Pedroza and Austin Rios conducted an unannounced Case Management inspection. LPA's contacted the facility prior to entering to conduct Covid-19 screening questions. LPA's met with facility Director Victoria De Leon and advised her the purpose of the inspection. Director provided LPA's tour of the facility inside and out. There were 67 children in care at the time of the inspection.

Community Care licensing (CCL) received an application for an increase in capacity from the facility on June 22, 2021. The facility is requesting to increase from 197 to 225 children. A fire clearance was requested on June 22, 2021. On July 13, 2021, Ventura County Fire Department conducted an inspection and granted the facility fire clearance. The facility will be using nine (9) classrooms for children in care.

Classroom measurements of the nine (9) classrooms and outdoor space along with sinks and toilets can accommodate the capacity increase of 225 children.

The center meets Title 22 Division 12 requirements.

License capacity increase will be effective today, July 23, 2021 for 225 children to include a toddler component of 24 children.

THE NOTICE OF SITE VISIT WAS POSTED AS REQUIRED BY H&S CODE SEC. 1596.817.
SUPERVISORS NAME: George Mingle
LICENSING EVALUATOR NAME: Francisco Pedroza
LICENSING EVALUATOR SIGNATURE: DATE: 07/23/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/23/2021
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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