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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343625307
Report Date: 02/12/2024
Date Signed: 02/12/2024 03:30:55 PM

Document Has Been Signed on 02/12/2024 03:30 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 CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:LEARNING PATCH CHILDREN'S CENTERFACILITY NUMBER:
343625307
ADMINISTRATOR:TSCHOEPE, DIANAFACILITY TYPE:
860
ADDRESS:6045 MARGO DRIVETELEPHONE:
(916) 741-7572
CITY:ORAGEVALESTATE: CAZIP CODE:
95662
CAPACITY: 100TOTAL ENROLLED CHILDREN: 100CENSUS: 45DATE:
02/12/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
10:10 AM
MET WITH:Diana TschoepeTIME COMPLETED:
03:45 PM
NARRATIVE
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While at the facility for another purpose, Licensing Program Analyst (LPA) Erwina Pascual-Golamco and LPA Jennifer Velasco observed three staff providing care who are not associated to the facility. LPAs verified the three staff have been cleared via Livescan, but none of the three are associated to the facility as required.
A Title 22 deficiency is being cited on continuation page LIC 809-D. Exit interview was conducted and report was reviewed with Facility Representative, Director Diana Tschoepe. Appeal rights were provided. Notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Jennifer Velasco
LICENSING EVALUATOR SIGNATURE: DATE: 02/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/12/2024
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 02/12/2024 03:30 PM - It Cannot Be Edited


Created By: Jennifer Velasco On 02/12/2024 at 11:48 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: LEARNING PATCH CHILDREN'S CENTER
FACILITY NUMBER: 343625307

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/12/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/01/2024
Section Cited
CCR
101170(e)

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(e) All individuals subject to a criminal record review ... shall prior to working, residing or volunteering in a licensed facility … (2) Request a transfer of a criminal record clearance as specified in Section 101170(f) or (3) Request and be approved for a transfer of a criminal record exemption ...
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Director stated they will follow up to ensure cleared staff are associated to the facility prior to having them work in the facility. Director stated they will provide evidence to LPA via email on or before the POC due date.
jennifer.velasco@dss.ca.gov
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This requirement is not met as evidenced by LPA's record review and observation that three staff who were cleared but not associated to the facility provided. This constitutes a potential health, safety, and/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:Natalie Dunaway
LICENSING EVALUATOR NAME:Jennifer Velasco
LICENSING EVALUATOR SIGNATURE:
DATE: 02/12/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/12/2024


LIC809 (FAS) - (06/04)
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