Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426213750
Report Date: 02/20/2018
Date Signed 02/20/2018 11:58:55 AM

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:LA PURISIMA CONCEPCION LITTLE SAINTS PRESCHOOLFACILITY NUMBER:
426213750
ADMINISTRATOR:TERESE MUNOZ-HILLFACILITY TYPE:
850
ADDRESS:219 W. OLIVE AVENUETELEPHONE:
(805) 736-6210
CITY:LOMPOCSTATE: CAZIP CODE:
93436
CAPACITY:87CENSUS: 71DATE:
02/20/2018
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Terese Munoz-HillTIME COMPLETED:
10:30 AM
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A case management visit was conducted by LPAs S. Mendoza-Ceja and G. Reyes who followed up on an incident that occurred on November 13, 2017. The incident was reported to the Department as required.

On November 13, 2017, teacher #1 was taking three children to the outside playground when child #1 got her finger stuck in the sliding accordion gate. Teacher #1 informed the Director of the incident. Teacher #2 administered first aid to child #1 while the Director contacted parent of child #1. Child #1 sustained an injury which required medical treatment.

Director stated this is the first time a child has sustained an injury with the gate. Director all staff members have been reminded to line the children up before the gate is opened and to watch the children to ensure there are no children next to the gate when opening it. Director stated she monitored the morning drop offs and after play time gate area to ensure the staff are supervising the children properly. Director stated she has also been reminding the parents to ensure this does not happen again.


No deficiencies cited.

LPA's observed the "Notice of Site Visit" posted.

FAILURE TO POST THE NOTICE OF SITE VISIT FOR 30 DAYS MAY RESULT IN A $100.00 CIVIL PENALTY.
SUPERVISOR'S NAME: Deborah AjaoTELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Sylvia Mendoza-CejaTELEPHONE: (805) 722-5132 FAX 685-1820
LICENSING EVALUATOR SIGNATURE:

DATE: 02/20/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/20/2018
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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