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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566212346
Report Date: 02/05/2025
Date Signed: 02/05/2025 01:21:49 PM

Document Has Been Signed on 02/05/2025 01:21 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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:TUTOR TIME CHILD CARE/LEARNING CENTER SVFACILITY NUMBER:
566212346
ADMINISTRATOR/
DIRECTOR:		VALERIE LOPEZFACILITY TYPE:
830
ADDRESS:1080 COUNTRY CLUB DRIVE WESTTELEPHONE:
(805) 582-0562
CITY:SIMI VALLEYSTATE: CAZIP CODE:
93065
CAPACITY: 40TOTAL ENROLLED CHILDREN: 40CENSUS: 21DATE:
02/05/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:15 AM
MET WITH:Heather Shields TIME VISIT/
INSPECTION COMPLETED:
01:40 PM
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On 2/5/2025 Licensing Program Analyst (LPA) German Negrete made an unannounced visit for the purpose of completing a Case Management - Incident inspection .Today LPA met with Center Director Heather Shields and LPA informed Director the purpose for todays inspection. Today, LPA did a walk through of the Child Care Center(facility) with the Center Director. LPA observed at the time of the walk-through 13 toddlers and 8 infants being supervised by 6 staff.

On 01/28/2025 Director contacted Community Care Licensing (CCL) to self-report the following unusual incident : On 1/28/25 at approximately 8:10 AM C1 was playing in the classroom when C1 tripped and fell. C1's head bumped the edge of the table which caused a cut on the forehead(see LIC812). S1 and S2 cleaned the area and applied Ice on C1's forehead. Director contacted Parent(P1) of C1 via telephone. According to Director, when P1 arrived to the facility P1 transported C1 to Los Robles Hospital/Emergency room.

During todays inspection LPA conducted children’s file review(see LIC857), staff file review(see LIC859). Also LPA obtained a photograph of C1's cut and a copy of the children's roster . Additionally LPA confirmed LIC624 was submitted by Director on 1/28/2025 via email.

More information needs to be obtained/verified before closing the case management review of the 1/28/2025 incident.


Exit interview was conducted and report was read to Director Heather Shieldsr.

Notice of site visit was provided.

SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: German Negrete
LICENSING EVALUATOR SIGNATURE: DATE: 02/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/05/2025
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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