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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701338
Report Date: 11/16/2022
Date Signed: 11/16/2022 04:37:59 PM

Document Has Been Signed on 11/16/2022 04:37 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, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:CFC LEARNING CENTER, LLCFACILITY NUMBER:
376701338
ADMINISTRATOR:SHONEIL WILSONFACILITY TYPE:
840
ADDRESS:2640-2642 OCEANSIDE BLVD.TELEPHONE:
(760) 721-5437
CITY:OCEANSIDESTATE: CAZIP CODE:
92054
CAPACITY: 6TOTAL ENROLLED CHILDREN: 6CENSUS: 6DATE:
11/16/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
03:40 PM
MET WITH:Shoneil WilsonTIME COMPLETED:
04:45 PM
NARRATIVE
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Licensing Program Analysts (LPAs) James Wilkerson and Susan Brewer arrived at this facility on this date. LPAs requested documents regarding (S1) Staff #1's qualifications as a School-Age teacher during this visit. Documentation was not available at this time for review as required by Title 22 Regulations.

SEE LIC 809D for deficiency cited.

An exit interview was conducted and a copy of this report will be provided to Ms. Wilson. A Notice of Site Visit will be posted and appeal rights were discussed and will be provided to Ms. Wilson.
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: James Wilkerson
LICENSING EVALUATOR SIGNATURE: DATE: 11/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/16/2022
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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Document Has Been Signed on 11/16/2022 04:38 PM - It Cannot Be Edited


Created By: James Wilkerson On 11/16/2022 at 03:43 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
, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: CFC LEARNING CENTER, LLC
FACILITY NUMBER: 376701338

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/16/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/15/2022
Section Cited
CCR
101217(a)

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Personnel Records - (a) The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. Each personnel record shall contain the following information: This requirement was not met as facility does not S1's teacher qualifications available for review
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S1 is no long employed at this facility,
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during this visit. This is a potential risk to the health and safety of 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:Carlos Martinez
LICENSING EVALUATOR NAME:James Wilkerson
LICENSING EVALUATOR SIGNATURE:
DATE: 11/16/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/16/2022


LIC809 (FAS) - (06/04)
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