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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566215335
Report Date: 05/19/2023
Date Signed: 05/19/2023 02:02:45 PM

Document Has Been Signed on 05/19/2023 02:02 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
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:FUSD - SESPE PRE SCHOOLFACILITY NUMBER:
566215335
ADMINISTRATOR:LORENA RAMOSFACILITY TYPE:
850
ADDRESS:627 SESPE AVETELEPHONE:
(805) 524-8202
CITY:FILLMORESTATE: CAZIP CODE:
93015
CAPACITY: 48TOTAL ENROLLED CHILDREN: 48CENSUS: 32DATE:
05/19/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Lorena RamosTIME COMPLETED:
12:30 PM
NARRATIVE
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On May 19, 2023 10:30 AM Licensing Program Analyst (LPA) Laura Villanueva and Licensing Program Manager (LPM) George Mingle made an unannounced inspection to conduct a Case Management-Incident visit. LPA and LPM met with Program Director, Lorena Ramos and explained the purpose of the visit. LPA observed a total of 32 children under the care and supervision of 5 staff.

On 5/2/23, an incident was reported informing of a child leaving the classroom and going to the front of the classroom. Staff interviewed stated they had a small group session at 1:00 P.M. and C1 was with the group. Staff was notified by a parent who brought the child back to the classroom at 1:15 P.M. The staff were not aware the child had left the group. The child was in a gated area at the front of the classroom and did not leave the school's premises. Child was found seated at the front of the classroom. Area where child was found posed no immediate risk to the child.

A type B deficiency was cited under Health & Safety Code 101229 Responsibility for Providing Care and Supervision. See LIC 9099D.) Today, deficiencies cited under Title 22 Division 12. Appeal rights given.

An exit interview was conducted with Program Director, Lorena Ramos. A copy of report was given and a notice of site visit was issued.
SUPERVISORS NAME: George Mingle
LICENSING EVALUATOR NAME: Laura Villanueva
LICENSING EVALUATOR SIGNATURE: DATE: 05/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/19/2023
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 05/19/2023 02:02 PM - It Cannot Be Edited


Created By: Laura Villanueva On 05/19/2023 at 11:45 AM
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: FUSD - SESPE PRE SCHOOL
FACILITY NUMBER: 566215335

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/19/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/19/2023
Section Cited
HSC
101229(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
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Program Director stated that: Placement of alarms on doors. Staff will view supervison video and share their reflection. A follow up meeting to establish a plan. Plan of correction will be completed by 5/31/23.
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 supervision of a teacher at any time,..Supervision shall include visual observation. This requirement was not met as evidenced by: A child left classroom without staff being aware. Child was left unsupervised. This poses a potential risk to the health and safety of the children 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: 05/19/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/19/2023


LIC809 (FAS) - (06/04)
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