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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566214141
Report Date: 07/18/2023
Date Signed: 07/19/2023 08:05:49 AM

Document Has Been Signed on 07/19/2023 08:05 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:EASTER SEALS VENTURA CDCFACILITY NUMBER:
566214141
ADMINISTRATOR:REBECCA KLAMSERFACILITY TYPE:
850
ADDRESS:10730 HENDERSON ROADTELEPHONE:
(805) 647-1141
CITY:VENTURASTATE: CAZIP CODE:
93004
CAPACITY: 122TOTAL ENROLLED CHILDREN: 122CENSUS: 75DATE:
07/18/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
04:02 PM
MET WITH:Catherine RutledgeTIME COMPLETED:
05:00 PM
NARRATIVE
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On July 18, 2023 at 4:02 PM Licensing Program Analyst (LPA) Laura Villanueva made an unannounced inspection to initiate a complaint investigation. There were 75 children with19 staff. During the tour of the facility with Director, Catherine Rutledge. LPA observed 2 children behind storage units next to fence in the outdoor area. Staff were not aware children went behind the storage units. A child placed his body in between 2 of the units. LPA asked Director if children were allowed to be there. Director responded no and informed teachers of the 2 children behind the storage units. The children were not in view of the staff.

Notice of Site Visit has been posted (LIC9213). The notice shall be posted for 30 consecutive days. Failure to maintain posting as required will result in a $100.00 civil penalty.

Exit interview conducted with Director, Catherine Rutledge. A copy of the Appeal Rights (LIC 9058 FAS 01/16) were given and explained. Licensee’s signature on this form acknowledges receipt of these rights. Web site address to obtain forms, review quarterly updates, review Title 22 & Health & Safety Codes is: https://www.cdss.ca.gov/inforesources/child-care-licensing

The following deficiencies are being cited in accordance to Title 22 of the California Code of Regulations and/or Health & Safety codes. Please refer to LIC809D for documentation of deficiencies cited: A type B citation is being issued under Section 101229 Responsibility for Providing Care and Supervision
SUPERVISORS NAME: George Mingle
LICENSING EVALUATOR NAME: Laura Villanueva
LICENSING EVALUATOR SIGNATURE: DATE: 07/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/18/2023
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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Document Has Been Signed on 07/19/2023 08:05 AM - It Cannot Be Edited


Created By: Laura Villanueva On 07/18/2023 at 04:13 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: EASTER SEALS VENTURA CDC
FACILITY NUMBER: 566214141

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/18/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/18/2023
Section Cited
HSC
101429(a)(1)

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101229 Responsibility for Providing Care and Supervision - (a) The licensee shall provide care and supervision as necessary to meet the children's needs. (1) No child(ren) shall be left without the supervision of a teacher at any time... Supervision shall include visual
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A written plan shall be sent to Department describing how teachers will provide care and supervision to children in care to ensure no incidents of lack of supervsion will occur in the future. The plan shall be submitted by: 7/28/23.
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observation. This requirement was not met as evidenced by: LPA observed 2 children behind storage units without teacher supervision. Based on LPA observations, the licensee did not comply with the section cited above which poses a potential health, safety or personal rights risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:George Mingle
LICENSING EVALUATOR NAME:Laura Villanueva
LICENSING EVALUATOR SIGNATURE:
DATE: 07/18/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/18/2023


LIC809 (FAS) - (06/04)
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