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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566213539
Report Date: 02/24/2025
Date Signed: 02/24/2025 11:48:51 AM

Document Has Been Signed on 02/24/2025 11:48 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: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: 45DATE:
02/24/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:33 AM
MET WITH:Kathryn DeanTIME VISIT/
INSPECTION COMPLETED:
11:14 AM
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On 2/24/2025 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 40 children and 5 toddlers being supervised by 8 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).

During the course of the investigation, 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).

LPA confirmed LIC624 written unusual incident report was submitted by Director on 1/31/2025 via email. LPA verified Director followed reporting requirements as outlined in Title 22 Californian Code of Regulations

As mentioned LPA interviewed Director and staff. Through these interviews LPA verified Staff who were supervising C1, noticed C1 in distress once the child fell in the play yard. LPA verified Staff and Director followed the guidelines listed under "observations of a child" (101626.3(b) in Title 22 CCR. Continued on LIC809-C

SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: German Negrete
LICENSING EVALUATOR SIGNATURE: DATE: 02/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/24/2025
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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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: 02/24/2025
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Furthermore LPA Interviewed P1, which revealed how P1 is happy with the care and supervision at the aforementioned center. P1 stated , P1 would recommend the childcare center.

This marks the conclusion /closure of the investigation.

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

Notice of site visit was provided.

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

DATE: 02/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2025
LIC809 (FAS) - (06/04)
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