401708427-12-8-2021-17-CC-EBAY-C9HTUT-20211208140252

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 401708427
Report Date: 12/08/2021
Date Signed: 12/08/2021 02:02:59 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:	VALLEY VIEW CHILDREN'S CENTER		FACILITY NUMBER:	401708427
ADMINISTRATOR:	JAMIE SANBONMATSU		FACILITY TYPE:	850
ADDRESS:	240 VERNON AVENUE		TELEPHONE:	(805) 481-7534
CITY:	ARROYO GRANDE	STATE: CA	ZIP CODE:	93420
CAPACITY:	65	CENSUS: 50	DATE:	12/08/2021
TYPE OF VISIT:	Case Management - Deficiencies	UNANNOUNCED	TIME BEGAN:	12:00 PM
MET WITH:	Jamie Sanbonmatsu		TIME COMPLETED:	01:45 PM

NARRATIVE

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On 12/8/21, at 12:00 PM, Licensing Program Analyst (LPA) Elvin Baddley conducted an unannounced Case Management Inspection of the abovementioned Child Care Center (CCC) as a follow up to an Unusual Incident Report (UIR) received by the Department on 11/17/21, pertaining to a child, herein, C1, being left in the CCC's classroom unattended. LPA notes Director submitted an UIR outlining the abovementioned to California Department of Social Service, Community Care Licensing Division on 11/18/21.

The LPA met with Jamie Sanbonmatsu, Director of the CCC and explained the purpose of the inspection. LPA, in the company of Director, visited the classroom (Classroom Four) where C1 was left unattended. The Director pointed out the location where C1 was located by facility staff. The Director also informed LPA of the location of other children and staff members, in relation/proximity to C1. Director noted teachers were taking the children to the CCC's restrooms, when C1 was left. Director also estimates the duration C1 was left unattended was about one minute.

LPA interviewed a facility teacher, herein S1, who confirmed a parent had informed of C1 being left unattended in the corner of the classroom. S1 noted the parent was dropping off a lunch bag in the classroom when the parent observed C1 unattended. S1 informed LPA S1 entered the classroom saw C1 in the corner of the classroom. S1 approached C1 and escorted C1 to the restroom area where the other teachers and children were located. In route to the aforementioned, the Assistant Director assumed care of C1.

Statements made by both S1 and the facility Director collaborated C1 was left in the CCC's classroom unsupervised/unattended.

Today, a deficiency is cited under Title 22 Division 12 Appeal rights given. Upon receipt of this report, Licensee shall post and provide copies of this licensing report to parents /guardian of children in care at the facility and to parent/guardians of children newly enrolled at the facility during the next 12 months. Licensee to provide LIC 9224 for each child in care and have each parent sign the form that they have received a copy of the report LIC 809 and LIC 809 D.

(CONT. 809-C)

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Elvin Baddley	TELEPHONE: (805) 635-4697
LICENSING EVALUATOR SIGNATURE:	DATE: 12/08/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/08/2021

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, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: VALLEY VIEW CHILDREN'S CENTER	FACILITY NUMBER: 401708427
	VISIT DATE: 12/08/2021

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THIS REPORT MUST BE FILED IN FACILITY FILE AND MADE AVAILABLE FOR PUBLIC REVIEW FOR 3 YEARS.

A closing interview was conducted with Director. A copy of this report was reviewed and provided to the Director.

The Notice of Site Visit was also provided to the Director as required by H&S Code Section 1596.817. The Notice of Site Visit must remain posted for 30 days or a civil penalty of $100.00 may apply.

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Elvin Baddley	TELEPHONE: (805) 635-4697
LICENSING EVALUATOR SIGNATURE:	DATE: 12/08/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/08/2021

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, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: VALLEY VIEW CHILDREN'S CENTER	FACILITY NUMBER: 401708427
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 12/08/2021

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 12/09/2021 Section Cited	1 2 3 4 5 6 7	Personal Rights- The licensee shall ensure that each child is accorded the following personal rights: To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs. This requirement was not met as evidence by C1 being left unattended in the CCC's classroom.
	8 9 10 11 12 13 14	This poses an immediate health, safety or personal rights risks to persons in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7
	1 2 3 4 5 6 7

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: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Elvin Baddley	TELEPHONE: (805) 635-4697
LICENSING EVALUATOR SIGNATURE:	DATE: 12/08/2021

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/08/2021

LIC809 (FAS) - (06/04)

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