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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566212127
Report Date: 10/15/2024
Date Signed: 10/15/2024 11:44:48 AM

Document Has Been Signed on 10/15/2024 11:44 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
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:GAN CAMARILLO PRESCHOOLFACILITY NUMBER:
566212127
ADMINISTRATOR/
DIRECTOR:		DEVORAH LEAH LANGFACILITY TYPE:
850
ADDRESS:2222 VENTURA BLVD.TELEPHONE:
(805) 982-0831
CITY:CAMARILLOSTATE: CAZIP CODE:
93010
CAPACITY: 30TOTAL ENROLLED CHILDREN: 30CENSUS: 19DATE:
10/15/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:30 AM
MET WITH:Devorah Leah LangTIME VISIT/
INSPECTION COMPLETED:
12:00 PM
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On 10/15/24, at 8:30 AM, Licensing Program Analyst (LPA) Elvin Baddley conducted an unannounced Three Year Required inspection of the abovementioned Child Care Center (CCC). LPA met with Devorah Leah Lang, Director of the CCC. LPA explained the purpose and nature of the inspection. The facility is located on the grounds of Studio Channel Island Art Center. The Preschool operates Monday – Thursday 9:00 AM – 4:00 PM and Friday from 9:00 AM - 2:00 PM. Currently the facility uses two classroom (Preschool Room and the Pre K/K Room) for child care services. At the time of inspection, LPA observed 19 children on site, along with four teachers (cleared and associated). The CCC's Director is assisting with the care and supervision of children on site.

The CCC is clean and orderly. LPA observed required licensing forms and documents posted on the walls of each classroom. LPA observed the CCC's Sign In/Out forms just outside the entry door of the classrooms. The forms contained the arrival and departure times of children in care and well as the signatures of the children's authorized representatives. The classrooms have age appropriate equipment and furnishings available to children in care. The CCC's carbon monoxide detector is integrated in the building's fire detection's system. The detector was not tested by LPA. Director informed LPA the fire detection system is regularly tested and monitored by the local fire Department.

The CCC uses two restrooms. All restrooms are in safe and sanitary operating condition. LPA observed a mini refrigerator in the CCC's office area which is capable of storing food for children in care. Lunches and snacks are provided by the parents of children in care. The CCC has supplemental food on site for children should the need arise. The CCC also has available (bottled) drinking water for children inside and outside of the facility. CCCs constructed before 1/1/20, to test their water (used for drinking and food preparation) for lead contamination before 1/1/23, and then every 5 years, except after the date of the first test. For CCC licenses issued after 7/1/22, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP). LPA verified that the lead testing was completed in accordance to the Written Directives outlined (CONT. LIC 809-C, Page 2)

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE: DATE: 10/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/15/2024
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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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: GAN CAMARILLO PRESCHOOL
FACILITY NUMBER: 566212127
VISIT DATE: 10/15/2024
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in PIN 21-21.1-CCP.

Disinfectants, cleaning solutions and sharps are observed in the CCC's supply room which is inaccessible to children in care and secure. Sharps and cleaning compounds in the classroom are in locations which are accessible to staff members but inaccessible to children in care.

The CCC outdoor playground areas are enclosed by chain linked fencing. The fence’s entry/exit gates are secured. The surfaces of the outdoor playground areas are varied. LPA observed a shed in the outdoor area which contains CCC's supplies. The shed is secured. LPA observed age appropriate play equipment in the play areas. The play equipment is free of sharp, loose or pointed objects. The play structures in the outdoor playground areas have adequate cushioning materials to absorb falls and shade created by building overhangs and awings. LPA reminded Director to replace outdoor play equipment and furnishings when such items begin to degrade or are not in good repair. No bodies of water are observed on site.

LPA reviewed children, staff and facility records. The children’s records sampled were complete and found to contain emergency contact information and immunization records, among other required licensing documentation and forms. Staff records were reviewed. Staff records sampled were complete and found to contain First Aid/CPR certifications (EMSA approved) and Mandated Reporter Training certification, among other required licensing documentation and forms. LPA notes the last disaster drill at the facility occurred on 9/16/24. No firearms or ammunition are stored on site.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of “medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication. Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

Facility representative was reminded that all adults 18 and over, including employees and volunteers,
as specified in HSC section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat (CONT. 809-C, Page 3)
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE:

DATE: 10/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2024
LIC809 (FAS) - (06/04)
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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: GAN CAMARILLO PRESCHOOL
FACILITY NUMBER: 566212127
VISIT DATE: 10/15/2024
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violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Facility representative Devorah Leah Lang.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE:

DATE: 10/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2024
LIC809 (FAS) - (06/04)
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