Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566215048
Report Date: 07/12/2016
Date Signed 07/12/2016 12:29:04 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:SOMIS COMMUNITY PRESCHOOLFACILITY NUMBER:
566215048
ADMINISTRATOR:NELLUM LEWISFACILITY TYPE:
850
ADDRESS:3300 WEST STREETTELEPHONE:
(805) 844-6093
CITY:SOMISSTATE: CAZIP CODE:
93066
CAPACITY:30CENSUS: 16DATE:
07/12/2016
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
10:18 AM
MET WITH:Nellum LewisTIME COMPLETED:
12:49 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
LPA Mingle made an unannounced visit in order to conduct an Annual/Random visit and met with Administrator, Ms. Nellum Lewis. The purpose of the visit was discussed and a tour of the facility was conducted.
There are no bodies of water present on the premises. Ms. Lewis stated that there are no firearms present on the premises.

The school was using two classrooms for day care when LPA arrived. Both classrooms have carpeted floors, cubbies, age appropriate toys, and learning materials for children in care.
The school has separate bathrooms for boys and girls which are located adjacent to each other outside the classrooms. LPA observed that teachers accompany children for bathroom breaks. Bathrooms inspected today were clean and free of litter. Food preparation area was inspected and found clean.

The play yard is fully fenced, has safe surface with enough cushion under high climbing equipment.
Staff records reviewed have evidence of training and experience. Children's files reviewed had emergency and identification information. Files drill are conducted and documented. Last drill was conducted on 6/7/16. CPR/First aid was current for staff present.

Ms. Lewis stated that the school does not provide incidental medical services -IMS at this time. IMS was discussed with administrator and a reference to www.ccld.ca.gov was made for a detail account on IMS.
All adults in the facility have obtained a criminal background clearance.

There were no deficiencies cited for today's inspection.
SUPERVISOR'S NAME: Patricia S. GutierrezTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: George MingleTELEPHONE: 805-562-0400
LICENSING EVALUATOR SIGNATURE:

DATE: 07/12/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/12/2016
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 1