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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566215294
Report Date: 11/20/2024
Date Signed: 11/20/2024 02:13:24 PM

Document Has Been Signed on 11/20/2024 02:13 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:CDR - SIMI HEAD STARTFACILITY NUMBER:
566215294
ADMINISTRATOR/
DIRECTOR:		SUZANNE GODINEZFACILITY TYPE:
850
ADDRESS:5455 KATHERINE ST.TELEPHONE:
(805) 485-7878
CITY:SIMI VALLEYSTATE: CAZIP CODE:
93063
CAPACITY: 20TOTAL ENROLLED CHILDREN: 20CENSUS: 14DATE:
11/20/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:10 PM
MET WITH:Carmelita GutridgeTIME VISIT/
INSPECTION COMPLETED:
02:30 PM
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On 11/20/24 at 12:10 AM, Licensing Program Analyst (LPA) Veronica Diaz conducted an unannounced Required-3 Year inspection. LPA met with site supervisor Carmelita Gutridge and advised them of the purpose of the inspection. Director provided LPA a tour of the facility inside and out. There were 14 children in care at the time of the inspection along with 4 staff. Center operates M-F 8:00AM-2:00PM.

LPA observed required licensing documents mounted on the walls in the entrance of the classroom. Last fire drill was conducted on 11/19/24 and disaster drill conducted on 11/06/24. The classrooms have age-appropriate toys and furniture accessible for children in care. LPA observed enough restrooms available for children to use. LPA did not observe any hazards/toxins items accessible to children. First Aid kit observed mounted on the wall in the classroom. Currently the facility uses an App called ChildPlus for children sign-in and sign-out. The facility also use app called LearningGenie, in person, and news letters for pictures and a form of communication to parents. Facility provides breakfast, lunch, and snack.

The outdoor playground is shaded and has an plenty amount of space for children to play. LPA observed the playground has age-appropriate toys and structures available for children to use.

A sampling of children and staff records were reviewed. LPA observed children's files to be complete and current. Staff mandated reporter certification are all current. LPA verified SB792 Child Care Adult Immunization and Tuberculosis requirements.

Continued on 809-C
SUPERVISORS NAME: Lissete Gonzalez
LICENSING EVALUATOR NAME: Veronica Diaz
LICENSING EVALUATOR SIGNATURE: DATE: 11/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/20/2024
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: CDR - SIMI HEAD START
FACILITY NUMBER: 566215294
VISIT DATE: 11/20/2024
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To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Site supervisor was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

Site supervisor was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100
Exit interview conducted and report was reviewed with site supervisor Carmelita Gutridge .
No deficiencies were cited.
SUPERVISORS NAME: Lissete Gonzalez
LICENSING EVALUATOR NAME: Veronica Diaz
LICENSING EVALUATOR SIGNATURE:

DATE: 11/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/20/2024
LIC809 (FAS) - (06/04)
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