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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566215650
Report Date: 07/02/2024
Date Signed: 07/02/2024 01:11:17 PM

Document Has Been Signed on 07/02/2024 01:11 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:EASTER SEALS CHILD DEVELOPMENT CENTERFACILITY NUMBER:
566215650
ADMINISTRATOR/
DIRECTOR:		REBECCA KLAMSERFACILITY TYPE:
830
ADDRESS:10730 HENDERSON ROADTELEPHONE:
(805) 647-1141
CITY:VENTURASTATE: CAZIP CODE:
93004
CAPACITY: 28TOTAL ENROLLED CHILDREN: 28CENSUS: 8DATE:
07/02/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:30 AM
MET WITH:Misbah SaadTIME VISIT/
INSPECTION COMPLETED:
01:25 PM
NARRATIVE
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On 4/12/2024, Licensing Program Analysts (LPAs) German Negrete and Sylvia Ceja conducted an unannounced inspection at the Easter Seals Center to deliver the findings of the complaint allegations received by the department on 1/16/2024. LPAs met with Director Misbah, LPAs toured the center inside and out. LPAs observed 3 infant teachers providing care and supervision to 8 infants.

During the investigation the center revealed there were multiple cases of RSV from the month of January 2024 and from the month of March 2024. Although the director reported the RSV cases to the Public Health Department, the director failed to report the RSV cases to Child Care Licensing Department. Therefore the facility is found to be in violations of Tittle 22 Division 12 Chapter 1 Article 6 Reporting Requirements 101212(d)(1)(E).

The Facility will receive a type B violation

Exit Interview conducted and report was reviewed with Director Misbah Saad
.
Notice of Site Visit and appeal rights were issued.
SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: German Negrete
LICENSING EVALUATOR SIGNATURE: DATE: 04/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/12/2024
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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Document Has Been Signed on 07/02/2024 01:11 PM - It Cannot Be Edited

Citations on this Visit Report are Under Appeal!


Created By: German Negrete On 04/12/2024 at 03:15 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: EASTER SEALS CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 566215650

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/02/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Under Appeal
Type B
07/05/2024
Section Cited
CCR
101212(d)(1)(E)

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Upon the occurrence, during the operation of the child care center of any of the events specified in (d)(1) below, a report shall be made to the Department by telephone or fax within the Department's next working day and during its normal business hours. In addition, a written report containing the information specified in (d)(2) below shall be submitted to the Department within seven days following the occurrence of such event. Epidemic outbreaks.
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The Director will review CCR Titile 22 101212(d)(1)(E) and submit a statement via email veifying that she fully undertstands the regulation for reporting requirements.
german.negrete@dss.ca.gov
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This regulation was not met due to facility failing to report multiple cases of RSV out breaks to the department as required.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Ana Tolentino
LICENSING EVALUATOR NAME:German Negrete
LICENSING EVALUATOR SIGNATURE:
DATE: 04/12/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/12/2024


LIC809 (FAS) - (06/04)
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