Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566215048
Report Date: 08/13/2015 12:00:00 AM
Date Signed 08/13/2015 11:51:55 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:SOMIS COMMUNITY PRESCHOOLFACILITY NUMBER:
566215048
ADMINISTRATOR:NELLUM LEWISFACILITY TYPE:
850
ADDRESS:3300 WEST STREETTELEPHONE:
(805) 844-6093
CITY:SOMISSTATE: CAZIP CODE:
93066
CAPACITY:30CENSUS: 0DATE:
08/13/2015
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
09:23 AM
MET WITH:Nellum LewisTIME COMPLETED:
11:54 AM
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LPAs Marie Trujillo and George Mingle met with the Director Nellum Lewis to conduct a prelicensing visit. An inspection of all indoor and outdoor activity spaces was conducted.

The preschool is located on the grounds of the Somis Community Church. Center will operate from 7:00 a.m. to 6:00 p.m. Two classrooms will be utilized for the preschool. Two year old classroom is separate from the combination 3 and 4 year old classroom. Furniture and equipment is in safe and good condition age appropriate for the ages of children being served. There are 6 toilets and 3 sinks available. One toilet and sink is located in the two year old classroom. Children will be supervised when going to the restrooms located outside the classroom. There is a changing table within arms length of a sink located in the two year old classroom restroom. Children will bring their own lunches and the center will provide two snacks daily. Kitchen is clean and sanitary. Cleaning products are stored in the kitchen and are inaccessible to children. There is drinking water available in the classroom by means of a water dispenser and disposable cups. There are drinking fountains in the outdoor activity area.

Playground has age appropriate toys and equipment. There is a canopy and portable shade sails to provide shade. All required forms are posted in the reception area for parent/authorized representative's view.

Discussed IMS procedures and the need for a Plan Of Operation if there is a need.

Fire inspection and fire clearance was approved on 7/27/15.

The indoor and outdoor activity space meets the measurements for the requested capacity of 30 children.

This facility is approved for center license for capacity of 30 children effective today, 8/13/15.
SUPERVISOR'S NAME: Patricia S. GutierrezTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Marie TrujilloTELEPHONE: (805) 722-5138
LICENSING EVALUATOR SIGNATURE:

DATE: 08/13/2015
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2015
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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