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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566216925
Report Date: 06/04/2024
Date Signed: 06/04/2024 01:08:33 PM

Document Has Been Signed on 06/04/2024 01:08 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:PACIFIC CAMPSFACILITY NUMBER:
566216925
ADMINISTRATOR/
DIRECTOR:
HARLEY, KENNETHFACILITY TYPE:
860
ADDRESS:380 ARNEILL ROADTELEPHONE:
(805) 482-5250
CITY:CAMARILLOSTATE: CAZIP CODE:
93010
CAPACITY: 180TOTAL ENROLLED CHILDREN: 180CENSUS: 0DATE:
06/04/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:00 AM
MET WITH:Heather ElkinsTIME VISIT/
INSPECTION COMPLETED:
01:20 PM
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On 06/04/2024 at 11:00am Licensing Program Analyst Rosie Breault conducted an announced pre-licensing inspection. Upon arrival, LPA met with director Heather Elkins. Inspection occurred with fire inspector Richard Martinez of the Ventura County Fire Department. This is a new application to serve school age children ages 4 years to 14 years for a maximum requested capacity of 105 children. The hours of operation will be Monday – Friday 7:00am-6:00pm during summer session and 1:00pm – 6:00pm during school session. At the time of the inspection, there were 0 children present. This facility is on the grounds of Good Shepard Lutheran Church and Preschool. This is a change of location from facility number #566210362.

LPA together with director toured and measured the on-limits areas and classrooms located at the facility. The facility utilizes a total of 4 classrooms labeled #1, #2, #3 and #4. This facility is located solely on the 2nd floor of the Education Building. There are 7 sinks and 8 toilets available for children’s use. At the time of the inspection, LPA observed children do not have access to Good Shepard children and do not share any physical indoor, outdoor space or restrooms and this was confirmed by director.

The facility was observed to be clean, safe, sanitary and in good repair. Parents/authorized representatives will utilize BrightWheel app for the purposes of signing in and out. The facility offers two snacks for children, and water is provided along with children bringing personal water bottles. Floors of all rooms have a surface that is safe and clean. Tables and chairs were observed to be maintained in good condition, free of sharp, loose or pointed parts. LPA observed windows in all classrooms within children’s height. At the time of the inspection, the windows were rendered inaccessible to opening by removal of the “hand crank.” Per director, children will not be napping at the facility. Toxins, poisons, and cleaning supplies will be rendered inaccessible to children and LPA viewed locked cabinets. Waste receptacles have tight fitting lids, first aid kit, and fire extinguisher present. Fire extinguisher last serviced on 3/28/2024. Carbon monoxide detector was functioning at the time of the inspection. Per director, no firearms or ammunition are present on the property, no bodies of water are present on the property.

SUPERVISORS NAME: Deborah Lowe
LICENSING EVALUATOR NAME: Maryrose Breault
LICENSING EVALUATOR SIGNATURE: DATE: 06/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/04/2024
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: PACIFIC CAMPS
FACILITY NUMBER: 566216925
VISIT DATE: 06/04/2024
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The outdoor area is enclosed by regulation fencing. The children utilize one main yard. LPA observed ample shade, and grass. Director stated water is available to children via jugs and personal water bottles.

Drinking water from a noncontaminating fixture or container shall be readily available both indoors and in the outdoor activity area. LPA advised per Health and Safety Code 1597.16(a)(1) Lead Testing and PIN-21-21-CCP Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010 to test their drinking water for lead contamination between January 1, 2020 and January 1, 2023, and then every 5 years after the date of the first test.

Per Written Directive 100700(c)(1) Written Directives for Lead Testing (1) For a license issued on or after July 1, 2022, initial testing results shall be received and posted within 180 days of licensure.

Medications shall be kept in a safe place inaccessible to children. A refrigerator shall be used to store any medication that requires refrigeration.

This facility plans to provide Incidental Medical Services – IMS. For IMS information, see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. A 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)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

Director was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, 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.

SUPERVISORS NAME: Deborah Lowe
LICENSING EVALUATOR NAME: Maryrose Breault
LICENSING EVALUATOR SIGNATURE:

DATE: 06/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2024
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: PACIFIC CAMPS
FACILITY NUMBER: 566216925
VISIT DATE: 06/04/2024
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LPA reviewed with program manager the LIC 311A, Records to Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted.

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

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms.

To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

Indoor capacity measures a total of 3,273.38 square feet. The outdoor measurement measures a total of 2,9996.88 square feet. Total measurements accommodate 93 children.

Fire clearance was approved on 06/04/2024.

License pending following corrections: Indoor classroom appropriate toys, equipment, and cubbies for individual items.

An exit interview was conducted with director Heather Elkins and copy of report provided.

SUPERVISORS NAME: Deborah Lowe
LICENSING EVALUATOR NAME: Maryrose Breault
LICENSING EVALUATOR SIGNATURE:

DATE: 06/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

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