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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566213539
Report Date: 08/23/2024
Date Signed: 08/23/2024 01:15:44 PM

Document Has Been Signed on 08/23/2024 01:15 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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:FREDRICKSON FAMILY EARLY CHILDHOOD CENTERFACILITY NUMBER:
566213539
ADMINISTRATOR/
DIRECTOR:		KATHRYN DEANFACILITY TYPE:
850
ADDRESS:3450 CAMPUS DR.TELEPHONE:
(805) 493-3247
CITY:THOUSAND OAKSSTATE: CAZIP CODE:
91360
CAPACITY: 57TOTAL ENROLLED CHILDREN: 57CENSUS: 27DATE:
08/23/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:27 AM
MET WITH:Director Kathryn DeanTIME VISIT/
INSPECTION COMPLETED:
01:25 PM
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On 08/23/2024 a Case Management Inspection was conducted by LPA German Negrete , who met with the Director Kathryn Dean. LPA advised the purpose of today's inspection was to complete a case management incident investigation. The unusual Incident that initiated the investigation was reported to the Department on 08/07/2024. Today LPA requested a toured of the facility. Director escorted LPA through the facility inside and outside. LPA observed 6 staff providing care and supervision to 31 children.

Director stated, that on 08/06/2024, during play time in the play yard at approximately 12:45pm C1 was playing with outlast blocks (play structure#1) in the play yard. C2 and C1 were building a structure and C2 dropped a block that landed on C1's left toe. The impact cut the toe of C1. S1 and S2 administered first aid, cleaned up the blood and S1 and S2 put ice on C1’s toe. S2 called C1 parents and dad arrived 25 minutes later, dad decided to take C1 to a doctor, and doctor determined C1 has a small fracture on the tip of the toe. S2 will include the doctors name in the LIC-624 report.

The investigation included, two unannounced inspections, staff interviews, Director interview and parent interview. Also LPA reviewed facility files/records and the manufacturer instructions for play structure#1.

Parent interview revealed C1 was transported to performance foot and ankle, where C1 was evaluated by a Podiatrist. Parent confirmed C1 received a fracture on the left toe. Parent also stated, how parent has observed children with out shoes at the facility. Furthermore, Parent stated, the facility care and supervision is amazing and the parent has no concerns with the aforementioned facility.

LPA also reviewed manufacturer instructions for play structure#1 that was submitted to the department via email by director. The manufacture instrcutions stated this play structure is designed for children 3 years old and up. LPA acknowledges and confirms the facility followed the age requirement listed in the manufacturer instructions for play structure#1.

Continued on LIC809-C

SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: German Negrete
LICENSING EVALUATOR SIGNATURE: DATE: 08/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/23/2024
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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: FREDRICKSON FAMILY EARLY CHILDHOOD CENTER
FACILITY NUMBER: 566213539
VISIT DATE: 08/23/2024
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During staff interviews and director interview LPA confirmed on the day of the incident there are two activities that are conflicting and have created a hazard. One activity allows general play to take place in the play yard, in which children can be barefoot. The other activity involved children playing with Outlast Blocks (playtructure#)1. Due to each block not uniformly weighing the same it is evident to the department, that at least one of the building blocks can create a hazard if it falls onto a child’s toe, but in particularly if the block falls onto a toe with out any shoe protection. Therefore, the department has found this facility was not in compliance with Title 22 California Code of Regulations.

Director stated, there will be a official policy written in the staff hand book, citing, children will not be barefoot in the building block area. Director stated she will email the updated handbook to LPA Negrete. Director will also draft a memo, that will notify all staff immediately about the new policy regarding close toe shoes are not permitted in the building block area outside.

Today the facility will receive a technical violation for section 101238.2(c) outdoor activity space.

Exit interview conducted with director. Report was read to director.

Notice of site visit was given.

Appeal rights were provided.

SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: German Negrete
LICENSING EVALUATOR SIGNATURE:

DATE: 08/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2024
LIC809 (FAS) - (06/04)
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