<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566215650
Report Date: 09/10/2024
Date Signed: 09/10/2024 03:14:34 PM

Document Has Been Signed on 09/10/2024 03:14 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: 83DATE:
09/10/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:30 PM
MET WITH:Misbah SaadTIME VISIT/
INSPECTION COMPLETED:
03:30 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 9/10/2024 Licensing Program Analyst (LPA) German Negrete made an unannounced visit for the purpose of conducting a Case Management - Incident inspection. LPA met with Center Director Misbah Saad discussed the purpose of the visit. During today’s inspection, LPA did a walk through of the Child Care Center(CCC) with the Center Director. At the time of the inspection LPA observed 83 children and 12 staff providing care and supervision.

On 07/30/2024, Director contacted Community Care Licensing (CCL) to self-report the following unusual incident : at approximately 9:15 AM during transition from indoors to outdoors, C1 followed children to the playground and then was left alone outside. C1 was between the preschool play ground gate entrance and the class room #2 door- entrance(see LIC812) Another teacher noticed that a child was left unattended for allegedly 1-2 minutes. Afterwards, the teacher brought C1 inside their own classroom and then took C1 to the playground. According to director the ratio at the time of the incident was 19 children with 4 teachers providing care and supervision.

The Unusual Incident Report (LIC624) was received on 08/04/2024 via email, therefore the CCC followed the appropriate time frame for submitting a written LIC624, as outlined in Title 22 California Code of Regulations.

Continued-809C

SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: German Negrete
LICENSING EVALUATOR SIGNATURE: DATE: 09/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/10/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
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: EASTER SEALS CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 566215650
VISIT DATE: 09/10/2024
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Today LPA conducted a document review and staff interviews.

LPA has requested staff roster, children’s roster(of current and previously enrolled staff) and a face recognition document for 7/30/2024. Also, LPA requested/received a copy of the policy memo the CCC provided to all staff. This memo references Title 22 California Code of Regulations section 101229. Finally LPA received a employee expectation review document that was signed by three staff members.

Due to insufficient information, the investigation/review of the 07/30/2024 incident is on going.

No deficiencies are being cited today.


Exit interview was conducted, report reviewed, and copy was provided to Center Director. Notice of site visit was given.

THE NOTICE OF SITE VISIT WAS POSTED AS REQUIRED BY H&S CODE SEC. 1596.817. THE NOTICE OF SITE VISIT MUST REMAIN POSTED FOR 30 DAYS OR A CIVIL PENALTY OF $100.00 WILL APPLY.

SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: German Negrete
LICENSING EVALUATOR SIGNATURE:

DATE: 09/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2024
LIC809 (FAS) - (06/04)
Page: 2 of 2