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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 196216378
Report Date: 11/04/2022
Date Signed: 11/04/2022 01:51:33 PM

Document Has Been Signed on 11/04/2022 01:51 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:KNOLLS LEARNING STUDIO - INFANT CENTER, THEFACILITY NUMBER:
196216378
ADMINISTRATOR:TRESSA MENDOZAFACILITY TYPE:
830
ADDRESS:28348 AGOURA ROADTELEPHONE:
(818) 991-7752
CITY:AGOURA HILLSSTATE: CAZIP CODE:
91301
CAPACITY: 4TOTAL ENROLLED CHILDREN: 4CENSUS: DATE:
11/04/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:28 PM
MET WITH:Tressa MendozaTIME COMPLETED:
02:15 PM
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On November 4, 2022 at 12:28 PM Licensing Program Analyst (LPA) Susana Martinez conducted an unannounced Case Management- Other inspection to deliver an approved waiver. LPA met with Tressa Mendoza and advised her the purpose of the inspection. Prior to entering the facility, LPA conducted a COVID-19 risk assessment. All answers indicated no COVID-19 risk is present. Licensee and LPA toured the facility inside and outside. At the time of the inspection there were 4 infants, 1 staff member (S1) and 1 volunteer (S2).

The infant program uses classrooms 1 and 3. Classroom 1 has the capacity of 8 children and Classroom 3 has the capacity of 7 children. In total the indoor classroom capacity was granted for 15 infants. The outdoor play area has the capacity of accommodating 4 infants at a time. Licensee submitted a waiver request to use the outdoor space on a staggered schedule for 4 infants at a time to maximize enrollment to their full capacity of 15 infants. The waiver request was granted on November 2, 2022. The staggered outdoor schedule is to be followed Monday- Friday. The young infant group will have outdoor time from 8 am- 10 am and again from 2 pm- 3 pm. The older infant group will have outdoor time from 11 am- 1 pm and again from 4 pm- 5 pm. The waiver request was granted subject to the following conditions: To adhere teacher child ratio of 1:4 at all times, to post a copy of the waiver in a visible location, to maintain the terms of this waiver at all times, and to immediately report any changes in existing conditions including construction or modifications to the existing outdoor space before the onset of such projects. Failure to comply with the conditions may result in termination of the waiver.

Continued on 809-C
SUPERVISORS NAME: George Mingle
LICENSING EVALUATOR NAME: Susana Martinez
LICENSING EVALUATOR SIGNATURE: DATE: 11/04/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/04/2022
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: KNOLLS LEARNING STUDIO - INFANT CENTER, THE
FACILITY NUMBER: 196216378
VISIT DATE: 11/04/2022
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No deficiencies were cited on today's visit.

Licensee 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.

An exit interview was conducted with licensee Tressa Mendoza and 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.
SUPERVISORS NAME: George Mingle
LICENSING EVALUATOR NAME: Susana Martinez
LICENSING EVALUATOR SIGNATURE:

DATE: 11/04/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2022
LIC809 (FAS) - (06/04)
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