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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 561709909
Report Date: 12/13/2024
Date Signed: 12/13/2024 11:32:47 AM

Document Has Been Signed on 12/13/2024 11:32 AM - 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:CONEJO VALLEY YMCA PEACH HILL SITEFACILITY NUMBER:
561709909
ADMINISTRATOR/
DIRECTOR:		JAMIE GONZALEZFACILITY TYPE:
840
ADDRESS:13400 CHRISTIAN BARRETT DR.TELEPHONE:
(805) 630-8621
CITY:MOORPARKSTATE: CAZIP CODE:
93021
CAPACITY: 60TOTAL ENROLLED CHILDREN: 60CENSUS: DATE:
12/13/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:45 AM
MET WITH:Katherine ObermanTIME VISIT/
INSPECTION COMPLETED:
11:45 AM
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Licensing Program Analysts (LPA) Veronica Diaz made an unannounced visit to conduct a Case Management Inspection. LPA met with Program Director, Katherine Oberman and explained the purpose of the inspection..

LPA interviewed Program Director, Director stated that Nicholas B. Norjean was employed on 08/10/2023 and is no longer employed since 12/10/24. LPA advise Program Director that Nicholas B. Norjean Accusation Exclusion Action against them, and they can no longer be associated or employed with children.

Based on the evidence obtained during today’s visit, LPA verified Nicholas B. Norjean is not present and is not employed in the facility. LPA advised the Director to disassociate the individual from their roster. Program Director stated that Nicholas Norjean received a background approval back from CDSS. LPA requested a copy of the approval letter Program Director stated that they will reach out the human resources (HR) for a copy. Program Director stated they received Guardian notification Exemption Denial on 06/28/24 and contacted Nicholas Norjean 07/01/24 to advice him to get an exemption clearance, on 12/09/24 Program Director stated they received a copy of the Accusation Denial Letter and 12/10/24 Nicholas Norjean was put on administrative leave and is no longer working in licensing facilities. Program Director stated they will contact HR to remover Nicholas Norjean from Guardian.

No deficiency was cited during today's visit.
Notice of site visit given
FAILURE TO POST THE NOTICE OF SITE VISIT FOR 30 DAYS MAY RESULT IN A $100.00 CIVIL PENALTY.
SUPERVISORS NAME: Lissete Gonzalez
LICENSING EVALUATOR NAME: Veronica Diaz
LICENSING EVALUATOR SIGNATURE: DATE: 12/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/13/2024
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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