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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 196216236
Report Date: 06/16/2022
Date Signed: 06/16/2022 03:37:19 PM

Document Has Been Signed on 06/16/2022 03:37 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
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:CALVARY WESTLAKE EARLY EDUCATION CENTERFACILITY NUMBER:
196216236
ADMINISTRATOR:ELAINA WHITEFACILITY TYPE:
850
ADDRESS:5495 VIA ROCASTELEPHONE:
(818) 991-8040
CITY:WESTLAKE VILLAGESTATE: CAZIP CODE:
91362
CAPACITY: 51TOTAL ENROLLED CHILDREN: 12CENSUS: 0DATE:
06/16/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Cari FoxTIME COMPLETED:
03:51 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 June 16, 2022 at 1:15 PM, Licensing Program Analyst (LPA) Dean Thompson conducted an announced Pre-licensing inspection. LPA met with ECE Consultant Cari Fox and advised the purpose of the inspection. Cari Fox provided LPA a tour of the facility inside and out. There were zero (0) children in care at the time of the inspection. Facility hours of operation are Monday thru Friday 8:30 AM to 3:30 PM.

Facility is located on a local church premises. LPA observed the required licensing documents mounted on the wall inside the facility. A posted snack menu was observed. Children will bring their own snacks and lunch from home. Families will be given the option to purchase morning/afternoon snacks if food is forgotten. The facility will be using three (3) classrooms for children in care. LPA observed each classroom had age appropriate toys, activities, and furniture readily accessible for children in care. The facility has two (2) restrooms readily available for children in care. Classroom #2 and #3 have a shared restroom between classes. Children in care will be offered a cot to sleep on if they choose to nap. The facility has one (1) outdoor recreation yard with age appropriate toys and structures. Water will be available for children inside and out.

Fire Safety Inspection was completed by the Los Angeles County Fire Department on June 6, 2022.

Indoor Square Footage of 2,331.00 meets the requirement for 45 children.
Outdoor Square Footage of 8,024.00 meets the requirement for 45 children.

LPA reviewed with Cari Fox the LIC 125 Entrance Checklist, Records To Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted. Licensee was made aware that it is the facility's responsibility to know the current regulations for a CCC which can be accessed on-line at www.cdss.ca.gov.

Continued on LIC 809-C
SUPERVISORS NAME: George Mingle
LICENSING EVALUATOR NAME: Dean Thompson
LICENSING EVALUATOR SIGNATURE: DATE: 06/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/16/2022
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 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: CALVARY WESTLAKE EARLY EDUCATION CENTER
FACILITY NUMBER: 196216236
VISIT DATE: 06/16/2022
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
ECE Consultant was reminded that all adults 18 and over, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

ECE Consultant was reminded a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter certification AB1207 every two years at www.mandatedreporterca.com

Incidental Medical Services (IMS) policy was discussed. For IMS information , see PIN 22-02-CCP. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm



Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.

To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010 to test their drinking water for lead contamination between January 1, 2020 and January 1, 2023, and then every 5 years after the date of the first test.

Continued on LIC 809-C

SUPERVISORS NAME: George Mingle
LICENSING EVALUATOR NAME: Dean Thompson
LICENSING EVALUATOR SIGNATURE:

DATE: 06/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2022
LIC809 (FAS) - (06/04)
Page: 2 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: CALVARY WESTLAKE EARLY EDUCATION CENTER
FACILITY NUMBER: 196216236
VISIT DATE: 06/16/2022
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
Based on the LPA observation, the following corrections need to be corrected prior to obtaining a regular child care center license.

CORRECTIONS
1. Preventative Health and Safety Practices certification for Director Stephanie Carver

The center meets Title 22 Division 12 requirements.

A provisional license will be effective today, June 16, 2022 for 45 children and will expire after 90 days if the corrections are not made.

THE NOTICE OF SITE VISIT WAS POSTED AS REQUIRED BY H&S CODE SEC. 1596.817.
SUPERVISORS NAME: George Mingle
LICENSING EVALUATOR NAME: Dean Thompson
LICENSING EVALUATOR SIGNATURE:

DATE: 06/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2022
LIC809 (FAS) - (06/04)
Page: 3 of 3