566212347-3-18-2022-17-CC-DTHN-CCMRGX-20220318130128

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 566212347
Report Date: 03/18/2022
Date Signed: 03/18/2022 01:01:34 PM

Document Has Been Signed on 03/18/2022 01:01 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 - Deficiencies	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 Deficiency visit and met with assistant director Heather Shields. LPA conducted the Covid-19 screening questions prior to entering the facility. Present during today's inspection were nineteen (19) children and one (1) staff inside the Pre-K classroom.

While touring the facility, LPA Thompson observed nineteen (19) children inside the Pre-K classroom along with one staff (S1) member. LPA Thompson asked asked assistant director if she knew what the ratio is and director stated one to 12. Director also mentioned that she was not made aware of the teacher being out of ratio.

The following deficiency is being cited under Title 22, Division 12, Chapter 1 - Teacher-Child Ratio. See attached LIC 809-D.

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.

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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Type A citation

LPA Dean Thompson informed assistant director Heather Shields that this report dated March 18, 2022 document(s) one (1) 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 Dean Thompson informed the assistant director Heather Shields to provide a copy of this licensing report dated March 18, 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.

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 01:01 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 A 04/01/2022 Section Cited	1 2 3 4 5 6 7	101216.3 TEACHER-CHILD RATIO There shall be a ratio of one teacher visually observing and supervising no more than 12 children in attendance, except as specified in (b) and (c) below.
	8 9 10 11 12 13 14	Based on observation, staff interviews and record review, the facility did not comply with 101216.3 TEACHER-CHILD RATIO. LPA observed staff (S1) providing care for nineteen (19) children alone which posses an immediate health, safety or personal rights risk 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: 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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