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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 573620071
Report Date: 05/28/2024
Date Signed: 05/28/2024 12:21:04 PM

Document Has Been Signed on 05/28/2024 12:21 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
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:
05/28/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:00 AM
MET WITH:director, Rosario IniguezTIME VISIT/
INSPECTION COMPLETED:
12:30 PM
NARRATIVE
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On May 28, 2024, Licensing Program Analyst (LPA), Lauren Scott and Licensing Program Manager (LPM) Chayntel Hunter, conducted an unannounced field visit to the facility. LPA toured the facility and observed five (5) infants being supervised by two (2) staff. LPAs determined through accessing Guardian that both of the teachers were not cleared and/or associated to the facility. Based on observation and review, facility did not ensure a criminal record clearance and/ or association of the two (2) staff members to the facility, which poses an immediate health, safety or personal rights risk to persons in care.

One Type A violation was assessed on a subsequent 809-D page. An exit interview was conducted, and the report was reviewed with the Director. Appeal Rights were provided to. 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.

LPA Scott informed director, Rosario Iniguez that this report dated 5/28/24 documents one Type A citation. Type A citations which shall be posted for 30 consecutive days as there is an immediate risks to the health, safety, or personal rights of children in care.

Also, LPA Scott informed the director to provide a copy of this licensing report dated 5/28/24 that documents any Type A citations 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.

SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: Lauren Scott
LICENSING EVALUATOR SIGNATURE: DATE: 05/28/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/28/2024
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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Document Has Been Signed on 05/28/2024 12:21 PM - It Cannot Be Edited


Created By: Lauren Scott On 05/28/2024 at 11:45 AM
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: 05/28/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/29/2024
Section Cited
CCR
101170(e)(1)

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All individuals subject to a criminal record review... prior to working...(1) Obtain a California clearance or a criminal record exemption as required by the Department...
This requirement was not met as evidenced by:
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Facility will remove both employees from the facility until a fingerprint clearance is obtained. Facility will ensure employees have proper background checks prior to starting at the facility. If facility has questions regarding clearances, they will contact CCLD or LPA. Facility will submit livescan forms to LPA
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Based on record review and interview, two staff members was not background cleared nor associated to the facility.
This poses an immediate health, safety, or personal rights risk to children in care.
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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: 05/28/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/28/2024


LIC809 (FAS) - (06/04)
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