426214409-8-15-2022-17-CC-GRES-CHBVDE-20220815162036

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 426214409
Report Date: 08/15/2022
Date Signed: 08/15/2022 04:20:45 PM

Document Has Been Signed on 08/15/2022 04:20 PM - It Cannot Be Edited

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:	VILLAGE VALLEY PRESCHOOL		FACILITY NUMBER:	426214409
ADMINISTRATOR:	MARIA E. ANGULO		FACILITY TYPE:	850
ADDRESS:	3346 CONSTELLATION ROAD		TELEPHONE:	(805) 733-7330
CITY:	LOMPOC	STATE: CA	ZIP CODE:	93436
CAPACITY:	32	CENSUS: 15	DATE:	08/15/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:55 AM
MET WITH:	Maria E. Angulo		TIME COMPLETED:	04:10 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	On 8/15/2022 at 11:55 AM , Licensing Program Analyst (LPA) Gigi Reyes conducted an unannounced 1 Year Required Inspection and met with Lead Teacher, Carissa Gonzales. LPA explained the purpose of the inspection. Prior to inspection LPA asked screening questions related to COVID -19 and responses indicate there are no COVID-19 exposure on site. The Child Care Center operates Monday to Friday, 7:45 AM to 4:00 PM. The Director, Ms Maria Angulo came in the facility 10 minutes later. LPA in the company of Ms. Angulo toured the Child Care Center inside and out. There were 15 children day care children and 3 staff present when LPA arrived. On or about 12:00 PM, only six (6) children were left and the rest were picked up by the parents. During the tour, Director stated that due to COVID -19 Pandemic, CCC now uses the front yard as the entrance for drop off and pick up of day care children. Prior to the pandemic, CCC's entrance was at the side of the parking lot area. LPA observed Licensing forms were not posted, Director stated that church scheduled the painting job this weekend and they have to remove the forms. LPA advised Staff 2 to post them in a bulletin board and place it in a prominent location. The outdoor playground is enclosed with fence and It has age appropriate toys and equipment. The playground has an ample amount of wood chip cushioning, there is sufficient shade for children's outdoor play. The CCC has drinking water available for children inside and out. Staff 2 stated CCC conducts fire and disaster drill every year. Director stated they conduct it every 6 months but there was no documentation. Center uses the manual sign-in/out sheet for each child which was found in compliance. A sampling of children and staff records were reviewed. Staff qualifications and requirements were reviewed and verified. Staff 2's Criminal Record Clearance was not associated to CCC's facility roster. Staff present have current Pediatric First Aid/CPR certificates that expire on 1/23/2023. LPA verified SB 792 Child Care Adult Immunization record and tuberculosis requirements. Director and Staff 3 did not renew the Mandated Reporter Training. Continued on LIC 809C

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi Reyes	TELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:	DATE: 08/15/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2022

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: VILLAGE VALLEY PRESCHOOL	FACILITY NUMBER: 426214409
	VISIT DATE: 08/15/2022

NARRATIVE

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During today's inspection, deficiencies were cited under Title 22 Division 12. Please refer to LIC809D for documentation of deficiencies cited and Technical Violation was issued. A civil penalty of $500.00 was assessed.

LPA Reyes informed the Director Maria Angulo that this report dated 8/15/2022 document(s) one Type A citation(s) which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.

Also, LPA Reyes informed the Director, Maria Angulo to provide a copy of this licensing report dated 8/15/2022 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

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

Continued on LIC 809 C

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi Reyes	TELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:	DATE: 08/15/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2022

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: VILLAGE VALLEY PRESCHOOL	FACILITY NUMBER: 426214409
	VISIT DATE: 08/15/2022

NARRATIVE

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To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

Director was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Director, Ms. Maria Angulo

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi Reyes	TELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:	DATE: 08/15/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2022

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 08/15/2022 04:20 PM - It Cannot Be Edited

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: VILLAGE VALLEY PRESCHOOL	FACILITY NUMBER: 426214409
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/15/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type A

Section Cited

CCR

101170(e)(2)

Criminal Record Clearance

(e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility: (2) Request a transfer of a criminal record clearance as specified in Section 101170(f) or This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above, Staff 2, Carissa Gonzales' Criminal Record Clearance is not associated with the Facility which poses an immediate health, safety or personal rights risk to persons in care.
	POC Due Date: 08/16/2022
	Plan of Correction
1 2 3 4	Director agreed to submit a written plan of correction on how to ensure that similar incident will be prevented from occuring no later than 8/16/2022. Transfer documents were submitted to CCL to associate Staff 2's CRC to the facility.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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: Gigi Reyes	TELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:	DATE: 08/15/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2022

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 08/15/2022 04:20 PM - It Cannot Be Edited

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: VILLAGE VALLEY PRESCHOOL	FACILITY NUMBER: 426214409
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/15/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101174(d)(2)

Disaster and Mass Casualty Plan

(d) Disaster drills shall be conducted at least every six months. (2) The drills shall be documented. This documentation shall be kept in the child care center for at least one year. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on interview and record review , the licensee did not comply with the section cited above in Director stated that they conduct it every 6 months but there was no documentation which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 08/25/2022
	Plan of Correction
1 2 3 4	Director agreed to submit the written plan of correciton to CCL no later than 8/25/2022

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review the licensee did not comply with the section cited above, Director and Staff 3 did not renew the Mandated reporter training which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 08/25/2022
	Plan of Correction
1 2 3 4	Licensee and Staff 3 agreed to renew and complete the mandated reporter training and submit proof no later than 8/25/2022

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: Gigi Reyes	TELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:	DATE: 08/15/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2022

LIC809 (FAS) - (06/04)

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