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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 561702359
Report Date: 02/06/2024
Date Signed: 02/07/2024 02:52:12 PM

Document Has Been Signed on 02/07/2024 02:52 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: 8DATE:
02/06/2024
TYPE OF VISIT:Case Management - Legal/Non-complianceUNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Hanna HomayounfarTIME COMPLETED:
03:15 PM
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On February 7, 2024 at 2:30 PM, An unannounced Case Management-Legal/Non-Compliance inspection was conducted on this date by Licensing Program Analyst (LPA) Laura Villanueva, who met with Teacher Assistant, Hanna Hamayounfar. The purpose for this inspection is to provide the center with a copy of Decision and Order to exclude staff, Tera L.Cardenas for a lifetime. A copy of the Decision and Order was served to staff by the Department on 11/14/2023.

Respondent TERA L. CARDENAS is prohibited from employment in, presence in, and contact with clients of, any facility licensed by the Department, certified or approved by a licensed foster family agency, or any resource family home, and from holding the position of member of the board of directors, executive director, or officer of the licensee of any facility licensed by the Department, for the remainder of Respondent's life.
Licensee is excluded from all care facilities licensed by the Department, certified by a licensed foster family agency, or any resource family home, and from holding the position of member of the board of directors, executive director, or officer of the licensee of any facility licensed by the Department for a lifetime, unless she successfully petition for reinstatement pursuant to Government Code section 11522. The Decision becomes final on 02/08/2024.

The following documentation was provided and explained:

· Decision and Order - CDSS No. 6423256101
·
Notice of Site Visit has been posted (LIC9213). The notice shall be posted for 30 consecutive days. Failure to maintain posting as required will result in a $100.00 civil penalty.

Exit interview conducted with Teacher Assistant, Hanna Homayounfar and a copy of this report was given.
SUPERVISORS NAME: George Mingle
LICENSING EVALUATOR NAME: Laura Villanueva
LICENSING EVALUATOR SIGNATURE: DATE: 02/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/06/2024
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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