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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197750029
Report Date: 10/12/2021
Date Signed: 10/12/2021 01:09:26 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:SUNSHINE LEARNING CENTERFACILITY NUMBER:
197750029
ADMINISTRATOR:DENTON NOVICKFACILITY TYPE:
850
ADDRESS:23720 WILEY CANYON ROADTELEPHONE:
(661) 254-6855
CITY:VALENCIASTATE: CAZIP CODE:
91355
CAPACITY:148CENSUS: 41DATE:
10/12/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:48 AM
MET WITH:Krista Ribbons, Assistant Director TIME COMPLETED:
01:15 PM
NARRATIVE
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On October 12, 2021 at 9:48am Licensing Program Analysts (LPA) Zirbes, Stepanyan and Licensing Program Manager (LPM) Ramon met with Assistant Director Krista Ribbons to conduct an unannounced case management inspection. The purpose of the case management was to follow up on a self-reported unusual incident report (UIR) submitted on to the Department on October 6, 2021. The unusual incident report was regarding a supervision incident involving staff 1 and child 1. Upon arrival, there were 41 children and 8 staff present at the facility.

During this inspection, interviews were conducted with staff and children. In addition, LPA's reviewed staff and children files including the facility video surveillance camera. Furthermore, LPA's also completed a safety inspection of the Center at approximately 10:00am.

Based on interviews and record, it was determined that C1 was left unsupervised in the breezeway of the facility for approximately three minutes. The incident occurred while two classrooms were transitioning from the outdoor play area to the classroom. A total of 17 children and three staff members were present when the incident occurred. 16 children and the three staff members walked through the door leading to the indoor area, however C1 did not enter the building and was left unattended in the breezeway. After approximately three minutes, staff 4 observed C1 and escorted C1 to the classroom. Statements obtained during the interviews disclosed that the breezeway is a secure area and children do not have access to exit the facility from the breezeway. Although the Administration took appropriate action to address staff 1's conduct, the care and supervision violation did occur.


A deficiency is being cited based on interviews and record review, in accordance with California Code of Regulations, Title 22, see LIC 809D.
An exit interview was conducted, where the plan of correction was reviewed and developed with Krista Ribbons, Assistant Director. A copy of this report and appeal rights were discussed with the Assistant Director.
SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Kendal ZirbesTELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:

DATE: 10/12/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2021
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: SUNSHINE LEARNING CENTER
FACILITY NUMBER: 197750029
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/12/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/26/2021
Section Cited

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101229 (a)(1) Responsibility for Providing Care and Supervision: No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation. This requirement is not met as evidenced by:
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Based on interviews and record, it was determined that C1 was left unsupervised in the breezeway of the facility for approximately three minutes. This poses a potential risk to the health, safety or personal rights of the children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Kendal ZirbesTELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:
DATE: 10/12/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/12/2021
LIC809 (FAS) - (06/04)
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