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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566215423
Report Date: 04/27/2022
Date Signed: 04/27/2022 03:45:07 PM

Document Has Been Signed on 04/27/2022 03:45 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:MY DESTINY PRE-SCHOOL & CHILD CARE CENTER, INC.FACILITY NUMBER:
566215423
ADMINISTRATOR:YOLANDA ANN JACKSONFACILITY TYPE:
850
ADDRESS:53 MOODY COURTTELEPHONE:
(310) 462-6348
CITY:THOUSAND OAKSSTATE: CAZIP CODE:
91360
CAPACITY: 24TOTAL ENROLLED CHILDREN: 28CENSUS: 25DATE:
04/27/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:35 PM
MET WITH:Yolanda JacksonTIME COMPLETED:
04:05 PM
NARRATIVE
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On April 27, 2022 at 12:35 PM, Licensing Program Analysts (LPA's) Dean Thompson and Susana Martinez conducted an unannounced Annual/Random inspection. LPA conducted the Covid-19 screening questions prior to entering the facility. LPA met with Krishnan Parameswari and advised the purpose of the inspection. LPA was able to tour the facility inside and out. There were 25 children in care at the time of the inspection.

While waiting for Director Yolanda Jackson to arrive, LPA's observed another child (C1) being signed in and allowed to enter the classroom by Krishnan Parameswari at 12:55 PM. With the addition to (C1), the total number of children in care was 26. Director Yolanda Jackson arrived at 12:57 PM and was advised, a licensee shall not operate a child care center beyond the conditions and limitations specified on the license, including the capacity limitations. LPA's observed Director Yolanda Jackson talking to (C1) parents and removing (C1) from the classroom. LPA also observed Director Yalanda Jackson making calls to get back into the capacity limitations.

LPA observed required licensing documents mounted on the walls throughout the facility. Last fire drill was conducted on 4/21/2022. Each of the classrooms have age-appropriate toys and furniture readily accessible for children in care. LPA observed enough restrooms available for children to use. LPA did not observe any hazards/toxins items accessible to children. Facility provides breakfast, lunch and snack. The outdoor playground is shaded and has an ample amount of space for children to play. LPA observed the playground has age-appropriate toys and structures available for children to use.


Continued on LIC 809-C
SUPERVISORS NAME: George Mingle
LICENSING EVALUATOR NAME: Dean Thompson
LICENSING EVALUATOR SIGNATURE: DATE: 04/27/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/27/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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: MY DESTINY PRE-SCHOOL & CHILD CARE CENTER, INC.
FACILITY NUMBER: 566215423
VISIT DATE: 04/27/2022
NARRATIVE
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A sampling of children and staff records were reviewed. LPA observed children's files to be complete and current. LPA reviewed three out of three staff files. CPR current with an expiration date of 9/2023. At the time of inspection two staff mandated reporter certification AB1207 was not available or inside the staff files. Director was reminded a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter certification AB1207 every two years at www.mandatedreporterca.com. LPA verified SB792 Child Care Adult Immunization and Tuberculosis requirements. LPA spoke with director about new Covid-19 guidelines. Facility is currently following Covid-19 guidelines. LPA observed staff wearing face masks, sanitizer and hand washing poster throughout the facility.
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


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.



Continued on LIC 809-C

SUPERVISORS NAME: George Mingle
LICENSING EVALUATOR NAME: Dean Thompson
LICENSING EVALUATOR SIGNATURE:

DATE: 04/27/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/27/2022
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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: MY DESTINY PRE-SCHOOL & CHILD CARE CENTER, INC.
FACILITY NUMBER: 566215423
VISIT DATE: 04/27/2022
NARRATIVE
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LPA Thompson informed Director Yolanda Jackson that this report dated 4/27/2022 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 Thompson informed the Director Yolanda Jackson to provide a copy of this licensing report dated 4/27/2022 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.

Two deficiencies were cited today. One Type A and one Type B

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

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

Exit interview conducted, appeal rights were given, and report was reviewed with director Yolanda Jackson

SUPERVISORS NAME: George Mingle
LICENSING EVALUATOR NAME: Dean Thompson
LICENSING EVALUATOR SIGNATURE:

DATE: 04/27/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/27/2022
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Document Has Been Signed on 04/27/2022 03:45 PM - It Cannot Be Edited


Created By: Dean Thompson On 04/27/2022 at 02:58 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: MY DESTINY PRE-SCHOOL & CHILD CARE CENTER, INC.
FACILITY NUMBER: 566215423

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/27/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
101161(a)
Limitations on Capacity and Ambulatory Status
(a) A licensee shall not operate a child care center beyond the conditions and limitations specified on the license, including the capacity limitation.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, and record review, the licensee did not comply with the section cited above. There were 25 children in care at the time of the inspection. LPA's observed another child (C1) being signed in and allowed to enter the classroom by Krishnan Parameswari at 12:55 PM. With the addition to (C1), the total number of children in care was 26 which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 04/27/2022
Plan of Correction
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LPA's observed Director Yolanda Jackson talking to (C1) parents and removing (C1) from the classroom. LPA also observed Director Yalanda Jackson making calls to get back into the capacity limitations. Director agrees to complete a written plan of correction on how to prevent being over the capacity limitations by 5/11/2022. Written plan of correction can be submitted to LPA via email, fax, or mail.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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
LICENSING EVALUATOR NAME:Dean Thompson
LICENSING EVALUATOR SIGNATURE:
DATE: 04/27/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/27/2022


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Document Has Been Signed on 04/27/2022 03:45 PM - It Cannot Be Edited


Created By: Dean Thompson On 04/27/2022 at 02:58 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: MY DESTINY PRE-SCHOOL & CHILD CARE CENTER, INC.
FACILITY NUMBER: 566215423

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/27/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
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
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Based on observation, interview, and record review, the licensee did not comply with the section cited above. Two out of three staff did not have proof of their mandated reporter certification AB1207 which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/11/2022
Plan of Correction
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Director was reminded a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter certification AB1207 every two years at www.mandatedreporterca.com Director agreed to submit proof of mandated reporter certifications for (S1) and (S2) by POC due date via email, fax, or mail.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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
LICENSING EVALUATOR NAME:Dean Thompson
LICENSING EVALUATOR SIGNATURE:
DATE: 04/27/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/27/2022


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