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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566217831
Report Date: 05/05/2026
Date Signed: 05/05/2026 11:27:18 AM

Document Has Been Signed on 05/05/2026 11:27 AM - 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:CVUSD PRESCHOOL AT MAPLEFACILITY NUMBER:
566217831
ADMINISTRATOR/
DIRECTOR:
AMIE MILLSFACILITY TYPE:
860
ADDRESS:3501 KIMBER DRIVETELEPHONE:
(805) 492-3567
CITY:NEWBURY PARKSTATE: CAZIP CODE:
91320
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 0DATE:
05/05/2026
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:43 AM
MET WITH:Amie MillsTIME VISIT/
INSPECTION COMPLETED:
11:35 AM
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On 5/5/2026 Licensing Program Analyst (LPA) Maryrose Breault conducted an announced prelicensing inspection at the above referenced facility for an application that was received to provide care for 24 preschoolers age 2 years – 5 years. This is a relocation of facility #566210649 CVUSD Preschool at Earths. Facility operates Monday – Friday 8:45am – 11:45am and is on the grounds of CVUSD Maple Elementary School.

LPA met with licensee representative Amie Mills and together toured and measured the on-limits areas and classrooms located at the facility. Facility will utilize BrightWheel for the purposes of signing in and out. LPA reminded licensee representative the person who signs the child in/out shall use his/her full legal signature and shall record the time of day. 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. Facility maintains a total of 9 sinks and 9 toilets, and 4 urinals available for children. Children do not have exclusive access to a restroom and will be utilizing the elementary “Blue Pod Bathrooms”. Licensee representative will submit waiver request for use of bathrooms. Per licensee representative, facility plans to provide snacks and children will bring water bottles.

NAME OF LICENSING PROGRAM MANAGER: Deborah Lowe
NAME OF LICENSING PROGRAM ANALYST: Maryrose Breault
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 05/05/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/05/2026
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: CVUSD PRESCHOOL AT MAPLE
FACILITY NUMBER: 566217831
VISIT DATE: 05/05/2026
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Preschoolers will utilize room Room #11 and at the time of the inspection, floors and surfaces of rooms were clean. Due to current operating facility (566210649) facility does not have all furniture and equipment present, however, will move over all items once licensure has been obtained. Due to half day program, facility does not provide nap time, however mat/cot is available for a child who would like to rest.

Licensee representative stated cleaning solutions, poisons and other items that could pose a danger if readily available to children will be stored in locked cabinet inaccessible to children. When medications are on site, licensee representative stated that they will be in the elementary school office. LPA observed first aid kits, carbon monoxide detector present and functioning, and fire extinguisher last serviced on 8/15/2025. Per licensee representative, no firearms or ammunition are present on property.

Ventura County fire clearance was granted on 4/7/2026.

LPA observed one outdoor play yard that currently is being used by elementary students age 4 -5 years old. LPA inspected outdoor play yard of elementary school that preschool wishes to use to provide care. LPA observed enclosed fencing at least 4 feet in height to keep children in the outdoor play area. Outdoor play areas provide ample shade, age-appropriate toys and equipment and structures, soft padding to absorb falls and sandbox free of debris. Per licensee representative, no bodies of water are present on property and LPA did not view any. Licensee representative will submit request for waiver to allow shared space.

There is one gated garden area that facility does not wish to use at this time; however, it may be used later. Licensee representative was reminded that any changes to the facility, both indoor and outdoor, must be reported prior to and approved by Community Care Licensing.

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

DATE: 05/05/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/05/2026
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: CVUSD PRESCHOOL AT MAPLE
FACILITY NUMBER: 566217831
VISIT DATE: 05/05/2026
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Preschool Measurements:

Total preschool indoor space measures 863.63 sq. ft. which will accommodate applicant’s request for 24 preschoolers.

Total preschool outdoor space measures 16684.44 sq. ft. which accommodate applicant’s request for 24 preschoolers.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP).

Licensee representative 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.

The following corrections are needed prior to issuance of the license: Request for both bathroom and outdoor yard waiver. Submission of passing lead test for bathrooms and sink & drinking fountain.

Exit interview conducted and report was reviewed with license representative Amie Mills, copy to be emailed.

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

DATE: 05/05/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/05/2026
LIC809 (FAS) - (06/04)
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