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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 561702359
Report Date: 10/02/2023
Date Signed: 10/02/2023 02:19:12 PM

Document Has Been Signed on 10/02/2023 02:19 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:CHRIST THE KING LUTHERAN PRESCHOOLFACILITY NUMBER:
561702359
ADMINISTRATOR:SARAH BRITTONFACILITY TYPE:
850
ADDRESS:3947 WEST KIMBER DRIVETELEPHONE:
(805) 499-7022
CITY:NEWBURY PARKSTATE: CAZIP CODE:
91320
CAPACITY: 56TOTAL ENROLLED CHILDREN: 56CENSUS: 15DATE:
10/02/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
01:56 PM
MET WITH:Sarah BrittonTIME COMPLETED:
02:30 PM
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On 10/2/23, Licensing Program Analyst (LPA) Elvin Baddley conducted an unannounced Case Management inspection to address the Reporting Requirement with the Child Care Center (CCC) Director. Specifically, LPA is to determine if the affected parents of children in care (C1 and C2) have been notified of physically and verbal abuse committed by S3. LPA met with Sarah Britton, Director of the CCC and advised of the purpose of the inspection. It should be noted LPA observed 16 children on site along with 5 teachers providing care and supervision.

LPA asked Director if the parent's of C1 and C2 have been notified of physically and verbal abuse committed by S3 at the CCC. Director informed LPA the parent's of C1 and C2 have not been notified of incidents of abuse committed by S3. LPA informed Director to author a narrative/letter/email and forward the narrative/letter/email to the parent's of C1 and C2 informing them of the incidents of abuse which were committed against C1 and C2 by S3.

LPA issued Director a Technical Violation with regard to CCR 101212 Reporting Requirements.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE: DATE: 10/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/02/2023
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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