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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 280106261
Report Date: 12/11/2023
Date Signed: 12/11/2023 12:18:44 PM

Document Has Been Signed on 12/11/2023 12:18 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
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:YOUNG WORLD OF LEARNINGFACILITY NUMBER:
280106261
ADMINISTRATOR:PERSAUD, TINAFACILITY TYPE:
850
ADDRESS:3765 OXFORD STREETTELEPHONE:
(707) 252-9330
CITY:NAPASTATE: CAZIP CODE:
94558
CAPACITY: 34TOTAL ENROLLED CHILDREN: 34CENSUS: 14DATE:
12/11/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:TIna Persaud/Peggy HowardTIME COMPLETED:
12:35 PM
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During the course of a complaint investigation, additional deficiencies were identified involving lack of supervision. Based on interviews conducted with children and parents from 10/26/2023 through 11/17/2023, it was determined that children are unsupervised on multiple occasions while at the facility.

Children interviews (C1-C8) provided corroborating evidence, confirming that children are alone while in the facility, specifically when going inside to use the restroom and while in a separate room with the door closed for time out. Furthermore, LPA observed two children on two different occasions walking alone into the facility from the back play yard to use the restroom. LPA also observed children alone in the restroom while a staff member was in another room.

Seven children interviews revealed that children are put into a room alone for time out with the door closed. A3 stated they observed a child was in a room alone and when the child tried to come out, staff member (S4) told the child to close the door and keep it closed. A6 stated they have observed children on different occasions sitting alone either at a table inside or in the corner with their heads down and no teacher present. S5 stated children are in the block room alone with the door closed while teachers are in the other room.

The following violation of the California Code of Regulations, Title 22; Division 12, were observed: see LIC 809D. Appeal Rights were provided.

Continued on LIC809C

SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Melinda Mohr
LICENSING EVALUATOR SIGNATURE: DATE: 12/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/11/2023
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
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME: YOUNG WORLD OF LEARNING
FACILITY NUMBER: 280106261
VISIT DATE: 12/11/2023
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Exit interview conducted, and report was reviewed with facility representative Peggy Howard.

LPA Mohr informed facility representative Peggy Howard that this report dated 11/12/2023 documents one Type A citation. Type A citations shall be posted for 30 consecutive days as there is an immediate risk to the health, safety, or personal rights of children in care.

Also, LPA Mohr informed facility representative to provide a copy of this licensing report dated 12/11/2023 that documents any Type A citation 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.




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: Leslie Lepori
LICENSING EVALUATOR NAME: Melinda Mohr
LICENSING EVALUATOR SIGNATURE:

DATE: 12/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/11/2023
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 12/11/2023 12:18 PM - It Cannot Be Edited


Created By: Melinda Mohr On 12/11/2023 at 09:09 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
, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

FACILITY NAME: YOUNG WORLD OF LEARNING
FACILITY NUMBER: 280106261

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/11/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
12/11/2023
Section Cited
CCR
101229(a)(1)

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101229 (a)(1) The licensee shall provide care and supervision as necessary to meet the children’s needs. No child(ren) shall be left without the supervision of a teacher at any time.... Supervision shall include visual observation.
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Licensee stated that if a child needs to use the restroom they will walk inside as a group, and will not let children be inside alone. LPA provided a handout "Active supervision at - a - glance" to give to staff and go over together at a staff meeting.
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This requirement is not met as evidenced by: Based on interviews, and observations, evidence shows that children are left alone in the facility without staff supervision. This poses a potential health, safety and/or personal rights risk to the 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:Leslie Lepori
LICENSING EVALUATOR NAME:Melinda Mohr
LICENSING EVALUATOR SIGNATURE:
DATE: 12/11/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/11/2023


LIC809 (FAS) - (06/04)
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