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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566216153
Report Date: 08/11/2022
Date Signed: 08/11/2022 04:30:02 PM

Document Has Been Signed on 08/11/2022 04:30 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:LARRIVEE FCC AKA SUNNYSIDE ADVENTURES PRESCHOOLFACILITY NUMBER:
566216153
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
08/11/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
03:30 PM
MET WITH:Kimberly LarriveeTIME COMPLETED:
04:44 PM
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On 8/11/2022, Licensing Program Analyst (LPA) Austin Rios met with Licensee Kim Larrivee and explained the purpose of the inspection. LPA conducted a Pre-screening with licensee prior to entering the home. Licensee had zero children in care at the time of the inspection. Together the LPA and licensee toured the home inside and outside.

The licensee uses the play room, living room, one bathroom, and backyard for the day-care. LPA observed two gates preventing access to the kitchen and bedrooms.There is a hot tub in the backyard with a cover and locks around it. On 8/4/2022 Ventura Fire Department conducted an inspection. Fire-Clearance for large facility was granted on 8/4/2022. The 2A10BC regulation fire extinguisher was observed in the kitchen with a purchase date of 8/2/2022. Toxins and hazards are inaccessible to the children. There are age appropriate toys and day-care equipment in the home. The back yard has age appropriate toys and day-care equipment. LPA advised licensee must provide visual supervision while the children are playing both inside the home and outside in the backyard. Licensee stated that there are no firearms or ammunition in the facility. First Aid/CPR certificates is valid until 6/2023. Mandated reporter training valid until 12/6/2023.

LPA discussed and verified SB 792 (Child Care Employee and Volunteer: Immunization and Tuberculosis Requirements). was informed walkers, bouncers and any similar object that restricts children's movement are prohibited from licensed facilities.

Licensee showed proof of her and assistants immunizations on file.

Cont. on 809C.

SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Austin Rios
LICENSING EVALUATOR SIGNATURE: DATE: 08/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/11/2022
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
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: LARRIVEE FCC AKA SUNNYSIDE ADVENTURES PRESCHOOL
FACILITY NUMBER: 566216153
VISIT DATE: 08/11/2022
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LPA Rios reviewed COVID-19 guidelines/resources with Licensee. LPA also reminded Licensee of the new child care regulations for infants and to continue monitoring the CCLD website at www.ccld.ca.gov for updates.

Facility license will be a large family childcare effective today, 8/11/2022 for a capacity of 14 children.

A copy of this report was reviewed and provided to the licensee.

THE NOTICE OF SITE VISIT WAS POSTED AS REQUIRED BY H&S CODE SEC. 1596.817. THE NOTICE OF SITE VISIT MUST REMAIN POSTED FOR 30 DAYS OR A CIVIL PENALTY OF $100.00 WILL APPLY.

SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Austin Rios
LICENSING EVALUATOR SIGNATURE:

DATE: 08/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/11/2022
LIC809 (FAS) - (06/04)
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