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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566213539
Report Date: 04/15/2026
Date Signed: 04/15/2026 12:32:23 PM

Document Has Been Signed on 04/15/2026 12:32 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: 49DATE:
04/15/2026
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:45 AM
MET WITH:Kathy DeanTIME VISIT/
INSPECTION COMPLETED:
12:50 PM
NARRATIVE
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On 04/15/2026, Licensing Program Analyst (LPA) Shane Loftus conducted an unannounced Case Management - Incident inspection at the above-mentioned Child Care Center (CCC) to follow up on an Unusual Incident Report (UIR) received by the Department on 04/13/2026. Specifically, a child in care (C1) sustained an injury to their chin. LPA met with Director, Kathy Dean and explained the nature of the inspection. LPA notes forty-nine (49) children are on site along with eight (8) staff providing care and supervision.

Director and LPA viewed the area where C1 sustained the injury. LPA notes the area is within the CCC's outdoor playground and the surface around the wooden steps is cushioned with wood chips. Director informed LPA that the incident occurred when C1 was running with other children in the playground. C1 was attempting to ascend a flight of three wooden steps leading to a wooden platform. C1 tripped and hit their chin on the top step of the flight, resulting in a cut to the chin. S1 witnessed the incident and immediately notified the Director while S2 applied basic first aid to C1’s injury. The Director then informed the parents of C1 who arrived at the CCC in under ten minutes. Director was informed that C1 was taken to the Emergency Room and received three stitches, but is otherwise showing no ill effects. LPA determined that the CCC took the appropriate and necessary actions after the incident occurred. LPA concluded that C1 was engaged in normal activities and there was no inherent hazard. LPA confirms the Director’s account of the incident corroborates the UIR submitted to Community Care Licensing (CCLD).

Continued on 809-C

NAME OF LICENSING PROGRAM MANAGER: Maria Mueller
NAME OF LICENSING PROGRAM ANALYST: Shane Loftus
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 04/15/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/15/2026
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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: 04/15/2026
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Based on observations and interviews with the Director, it is determined that neither the equipment at the CCC nor the actions of the CCC's staff contributed to C1's incident. LPA best categorized the incident as an unfortunate accident.

No deficiencies were cited during today’s inspection. Exit interview conducted and report was reviewed with the facility representative, Kathy Dean.

NAME OF LICENSING PROGRAM MANAGER: Maria Mueller
NAME OF LICENSING PROGRAM ANALYST: Shane Loftus
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/15/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2026
LIC809 (FAS) - (06/04)
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