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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 573620071
Report Date: 04/29/2024
Date Signed: 04/29/2024 03:28:04 PM

Document Has Been Signed on 04/29/2024 03:28 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
SACRAMENTO SOUTH, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:TWINKLE LITTLE STAR CENTERFACILITY NUMBER:
573620071
ADMINISTRATOR/
DIRECTOR:		INIGUEZ, JOSEFINAFACILITY TYPE:
830
ADDRESS:1401 EAST GUM AVETELEPHONE:
(530) 204-9709
CITY:WOODLANDSTATE: CAZIP CODE:
95776
CAPACITY: 12TOTAL ENROLLED CHILDREN: 12CENSUS: 5DATE:
04/29/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:45 PM
MET WITH:Director, Josephina IniguezTIME VISIT/
INSPECTION COMPLETED:
03:45 PM
NARRATIVE
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April 29, 2024, Licensing Program Analysts (LPAs) Lauren Scott and Janie Davis conducted a case management inspection at the facility. LPAs met with Director, Josephina Iniguez.

Upon arrival, LPA's observed 5 infants sleeping in cribs with one staff. The one staff left the infant room to unlock the door for LPA's to enter the facility, leaving the 5 infants unattended without proper supervision. Based on interviews with staff and LPA observations, the facility did not provide proper supervision to children in care.

Title 22 deficiencies for absence of supervision have been cited on subsequent page, LIC 809D.

An exit interview was conducted, and a Plan of Correction was reviewed and developed with the Director, Josephina Iniguez. A copy of this report and appeal rights were discussed and left for Director. A Notice of Site Visit was posted by LPA and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: Lauren Scott
LICENSING EVALUATOR SIGNATURE: DATE: 04/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/29/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
Document Has Been Signed on 04/29/2024 03:28 PM - It Cannot Be Edited


Created By: Lauren Scott On 04/29/2024 at 02:05 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
, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: TWINKLE LITTLE STAR CENTER
FACILITY NUMBER: 573620071

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/29/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
04/30/2024
Section Cited
CCR
101229(a)(1)

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101229(a)(1) ...no children shall be left without the supervision of a teacher at any time... Supervision shall include visual observation.
This requirement was not met as evidenced by:
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Facility will conduct a staff training regarding supervision of children, including how to access the front door if needing to be opened while in ratio. Staff will discuss lunch and break schedules as well. Facility will submit meeting notes to LPA with staff signatures
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Based on LPA observations, LPAs observed infant teacher leave the infant room to open the front door of the facility, with the inability to see the infants in the infant room.

This poses an immediate health and safety risk to children in care.
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CIVIL PENALTIES HAVE BEEN ASSESSED

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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:Chayntel Hunter
LICENSING EVALUATOR NAME:Lauren Scott
LICENSING EVALUATOR SIGNATURE:
DATE: 04/29/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/29/2024


LIC809 (FAS) - (06/04)
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