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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566213539
Report Date: 02/05/2025
Date Signed: 02/05/2025 03:35:45 PM

Document Has Been Signed on 02/05/2025 03:35 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: 21DATE:
02/05/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:02 PM
MET WITH:Kathryn DeanTIME VISIT/
INSPECTION COMPLETED:
03:40 PM
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On 2/5/2025 Licensing Program Analyst (LPA) German Negrete made an unannounced visit for the purpose of completing a Case Management - Incident inspection . Today LPA met with Center Director Kathryn Dean. LPA informed Director the purpose for todays inspection. LPA did a walk through of the Child Care Center with the Center Director. LPA observed at the time of the walk-through 21 children being supervised by 6 staff.

On 1/30/2025, Director contacted Community Care Licensing (CCL) to self-report the following unusual incident: C1 was running on the playground, playing a chasing game with other children. The first child and second child stumbled forward and fell down, catching themselves with their hands. C1 bumped into the two children and fell face first onto the cement. C1's nose, forehead and lips were slightly red and a small scratch was on the side of the nose. According to Director, the other two children did not have any injuries(see LIC812).

Today LPA interviewed staff and conducted a children's file review. Also LPA obtained a copy of a photograph pertaining to C1's nose and forehead(See LIC812). Additionally LPA verified the written Unusual Incident report (LIC624) was submitted to the department on 1/31/2025 via email.

More information needs to be obtained/verified before closing the case management review of the 1/29/2025 incident involving C1.


Exit interview conducted and report was read to Director Kathryn Dean.

Notice of site Visit was provided and must remain posted for 30 days.

SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: German Negrete
LICENSING EVALUATOR SIGNATURE: DATE: 02/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/05/2025
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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