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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566217680
Report Date: 10/23/2025
Date Signed: 10/23/2025 12:37:44 PM

Document Has Been Signed on 10/23/2025 12:37 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:NEWBURY OAKS PRESCHOOLFACILITY NUMBER:
566217680
ADMINISTRATOR/
DIRECTOR:		TANYA MEZAFACILITY TYPE:
860
ADDRESS:53 MOODY COURTTELEPHONE:
(805) 376-5500
CITY:THOUSAND OAKSSTATE: CAZIP CODE:
91360
CAPACITY: 32TOTAL ENROLLED CHILDREN: 32CENSUS: 0DATE:
10/23/2025
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:42 AM
MET WITH:Kristina GolemTIME VISIT/
INSPECTION COMPLETED:
12:43 PM
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On 10/23/2025, Licensing Program Analyst (LPA) Rosie Breault conducted an announced pre-licensing inspection at the above-mentioned facility to ensure that health, safety, and personal rights as required by Title 22 and Health and Safety Regulations governing California Child Care Centers will be met. LPA met with applicant who requested relocation of facility #566214418. The facility will operate Monday – Friday 6:30AM-6:00PM and requests to provide care for 18 preschoolers age 2 years to 6 years, 8 toddlers age 18 months to 24 months and 6 infants age 6 months to 18 months.

LPA met with applicant Kristina Golem and together toured and measured the on-limits areas and classrooms located at the facility. The preschool children will utilize “Preschool Room”, toddlers to utilize “Toddler Room” and infants to utilize “Infant Room”. Facility maintains a total of 5 sinks and 3 toilets.

LPA observed regulation postings placed in a prominent location, and facility will utilize ProCare app for purposes of signing in and out. Facility is equipped with a room to isolate and care for any child who becomes ill during the day, with space for cot/mat, separate toilet, and sink, affords easy supervision, and not located in or near food or general toilet area.

The facility was observed to be clean, safe, sanitary and in good repair and must remain at all times to ensure the safety and well-being of children, employees, and visitors. Floors of all rooms have a surface that is safe and clean. All classroom furniture and equipment were observed to be maintained in good condition, free of sharp, loose or pointed parts. Tables and chairs were observed to be meet the needs of the children. All play equipment and materials used by children were observed to be age appropriate, and personal cubby space is available to children.

Both the preschool classroom and toddler classroom contain a variety of activities for children, comfortable temperature, ample ventilation, and sufficient number of cots for the requested number of children. LPA observed waste receptacles to have tight fitting covers, in good repair, leakproof and rodent-proof. Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to children stored in the closed kitchen. LPA observed first aid kits. Per applicant, no firearms or ammunition are present on property.

NAME OF LICENSING PROGRAM MANAGER: Deborah Lowe
NAME OF LICENSING PROGRAM ANALYST: Maryrose Breault
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 10/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/23/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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: NEWBURY OAKS PRESCHOOL
FACILITY NUMBER: 566217680
VISIT DATE: 10/23/2025
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Infant classrooms contain soft flooring, and manipulatives are available for children and ample ventilation. Infant napping area is separated from play space in its’ own room with no door. LPA observed sitting area for staff to allow for observation. LPA observed regulation cribs, tight fit sheets, space between cribs for room to walk around and do not hinder the entrance and exit. LPA advised applicant must always adhere to Safe Sleep Regulations including 15-minute recorded sleep logs.

LPA observed one outdoor play yard. Play area provides ample shade, age-appropriate toys and equipment and structures, and soft material to absorb falls. Per regulation there shall be 75 square feet of outdoor space, and no commingling may exist between age groups, the applicant will submit an outdoor waiver request.

Parents will provide lunch, and facility will provide AM/PM snacks and filtered water available. LPA observed kitchen to be clean, free of rodents or pests and in good working order.

Ventura County Fire Inspector Richard Martinez conducted fire inspection in tandem with LPA.

Drinking water from a non contaminating 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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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)/ (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

NAME OF LICENSING PROGRAM MANAGER: Deborah Lowe
NAME OF LICENSING PROGRAM ANALYST: Maryrose Breault
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2025
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: NEWBURY OAKS PRESCHOOL
FACILITY NUMBER: 566217680
VISIT DATE: 10/23/2025
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Applicant 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.

Applicant was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain childcare by connecting them to childcare 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.

Preschool room measures 580.12 sq. ft. which will not accommodate applicants’ request for 18 preschoolers.

Toddler room measures 280.53 sq. ft. which will accommodate applicants’ request for 8 toddlers.

Infant room measures 219.00 sq. ft. which will accommodate applicants’ request for 6 infants.

Outdoor play area measures 910.00 sq. ft., which will not accommodate applicants’ request for 32 children. Applicant to submit outdoor waiver.

License pending: Area behind and to the side of large fort to have 4 foot barriers installed, add infant play room gate, add infant changing table, service fire extinguisher, carbon monoxide detectors to be installed properly (per inspector) and final fire approval.

An exit interview conducted with applicant Kristina Golem, copy of report to be emailed.

NOTICE OF SITE VISIT TO REMAIN POSTED IN A PROMINENT LOCATION FOR 30 DAYS.

NAME OF LICENSING PROGRAM MANAGER: Deborah Lowe
NAME OF LICENSING PROGRAM ANALYST: Maryrose Breault
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2025
LIC809 (FAS) - (06/04)
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