Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566213009
Report Date: 12/01/2017
Date Signed 12/01/2017 04:59:56 PM

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:THREE ANGELS PRE-SCHOOL AND INFANT CENTERFACILITY NUMBER:
566213009
ADMINISTRATOR:MARY WIGGINSFACILITY TYPE:
840
ADDRESS:6300 TELEPHONE RD.TELEPHONE:
(805) 639-0363
CITY:VENTURASTATE: CAZIP CODE:
93003
CAPACITY:28CENSUS: 12DATE:
12/01/2017
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
03:46 PM
MET WITH:Mary WigginsTIME COMPLETED:
05:13 PM
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Licensing Program Analyst, LPA Mingle made an unannounced visit in order to conduct an Annual/Random review and met with the director, Ms. Mary Wiggins. The purpose of the visit was discussed and together a tour of the facility was conducted.
There were no bodies of water present. Children were observed outside when LPA arrived. The center uses the gym for the school age program. This space was inspected and found free of hazards. Bathrooms were located outside the classrooms with separate bathrooms for boys and girls. Disinfectants and cleaning supplies were inaccessible to children in care. Sign in/out sheet had full signature and time.
Furniture and play equipment were in good repair. Outdoor space was fully fenced and free of hazards. Storage containers for solid waste had tight - fitting lids.
Drinking water was available both inside and outside. The center was operating within its capacity specified on license. All adults present have obtained a criminal record clearance. Staff present had current CPR/First aid certification.
Children files reviewed had identification and emergency information, and notification of parents rights. Personnel file had documentation of education and experience and proof of immunization as mandated by SB792.
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

There were no deficiencies cited for today's visit.

SUPERVISOR'S NAME: Patricia S. GutierrezTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: George MingleTELEPHONE: 805-562-0400
LICENSING EVALUATOR SIGNATURE:

DATE: 12/01/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2017
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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