566212347-3-18-2022-17-CC-DTHN-CCMRC2-20220318125336

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 566212347
Report Date: 03/18/2022
Date Signed: 03/18/2022 12:53:42 PM

Document Has Been Signed on 03/18/2022 12:53 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:	TUTOR TIME CHILD CARE/LEARNING CENTER SV		FACILITY NUMBER:	566212347
ADMINISTRATOR:	VALERIE LOPEZ		FACILITY TYPE:	840
ADDRESS:	1080 COUNTRY CLUD DRIVE WEST		TELEPHONE:	(805) 582-0562
CITY:	SIMI VALLEY	STATE: CA	ZIP CODE:	93065
CAPACITY:	25	CENSUS: 19	DATE:	03/18/2022
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME BEGAN:	09:10 AM
MET WITH:	Heather Shields		TIME COMPLETED:	01:20 PM

NARRATIVE

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On March 18, 2022 at 9:10 AM, Licensing Program Analyst (LPA) Dean Thompson conducted an unannounced Case Management- Incident inspection. LPA met with facility assistant Director Heather Shields and advised her the purpose of the inspection. Covid pre-screening questions were asked to make sure no one inside has tested positive for COVID or have any flu like symptoms. Director provided LPA a tour of the facility. There were 19 children in care at the time of the inspection inside the Pre-K classroom with one staff.

On 3/17/2022, Director V. Lopez contacted Community Care Licensing (CCL) to self-report an incident of a day care child being left unattended in the Pre-K classroom for five (5) minutes. Staff (S1) was unaware the child went to the restroom as the children were going outside.

LPA requested video footage but was unable to obtain the video at the time of inspection.

On 3/18/2022 at or around 11:30 AM, LPA Thompson interviewed assistant Director Heather Shields and other staff members regarding the incident.

Continued on LIC 809-C

SUPERVISOR'S NAME: George Mingle	TELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Dean Thompson	TELEPHONE: (805) 729-8797
LICENSING EVALUATOR SIGNATURE:	DATE: 03/18/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/18/2022

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: TUTOR TIME CHILD CARE/LEARNING CENTER SV	FACILITY NUMBER: 566212347
	VISIT DATE: 03/18/2022

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Staff interviews were conducted on March 18, 2022 and was determined C1 was left inside the classroom unattended for approximately five minutes. It was determined by staff interviews, when C1 was found inside the classroom, C1 was in distress and looked scared.

LPA reviewed S1 file and it was determined that S1 was issued a final written warning noticed on March 17, 2022 for child supervision and face to name under the facilities policy and /or procedure violation.

Based on LPA observations and interviews which were conducted and record review(s), the preponderance of evidence standard has been met, therefore the above allegation(s) is found to be SUBSTANTIATED. California Code of Regulations, (Title 22, Division & Chapter number), are being cited on the attached LIC 809 D.

Training video - https://ccld.childcarevideos.org/

LPA Thompson informed assistant director Heather Shields that this report dated March 18, 2022 document(s) one (1) of Type B citation.

Notice of Site Visit

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

Posting Requirements

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

Exit Interview

Exit interview conducted and report was reviewed with the assistant director Heather Shields.

SUPERVISOR'S NAME: George Mingle	TELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Dean Thompson	TELEPHONE: (805) 729-8797
LICENSING EVALUATOR SIGNATURE:	DATE: 03/18/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/18/2022

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 03/18/2022 12:53 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: TUTOR TIME CHILD CARE/LEARNING CENTER SV	FACILITY NUMBER: 566212347
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/18/2022

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 04/01/2022 Section Cited	1 2 3 4 5 6 7	Responsibility for Providing Care and Supervision (a) The licensee shall provide care and supervision as necessary to meet the children's needs. (1) 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:
	8 9 10 11 12 13 14	Based on staff interview and record review, C1 was left unattended inside the Pre-k classroom for approximately for five (5) minutes and was found in distress, which poses an immediate health, safety or personal rights risk to persons in care.	8 9 10 11 12 13 14	In addition to the wriiten plan, an informal conference will be scheduled by 4/1/2022.
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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: George Mingle	TELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Dean Thompson	TELEPHONE: (805) 729-8797
LICENSING EVALUATOR SIGNATURE:	DATE: 03/18/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/18/2022

LIC809 (FAS) - (06/04)

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