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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426214409
Report Date: 07/15/2024
Date Signed: 07/15/2024 04:34:30 PM

Document Has Been Signed on 07/15/2024 04:34 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 BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:VILLAGE VALLEY PRESCHOOLFACILITY NUMBER:
426214409
ADMINISTRATOR/
DIRECTOR:		MARIA E. ANGULOFACILITY TYPE:
850
ADDRESS:3346 CONSTELLATION ROADTELEPHONE:
(805) 733-7330
CITY:LOMPOCSTATE: CAZIP CODE:
93436
CAPACITY: 32TOTAL ENROLLED CHILDREN: 32CENSUS: 2DATE:
07/15/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
04:10 PM
MET WITH:Maria AnguloTIME VISIT/
INSPECTION COMPLETED:
04:40 PM
NARRATIVE
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LPAs conducted a visit to the center and met with Licensee/Director Maria Angulo and Carissa Gonzales Angulo and discussed the purpose of the inspection. During the course of Complaint Investigation #17-CC--20240419161004, LPAs S. Mendoza-Ceja and G. Negrete reviewed sign/in and out sheets. It was found the Sign in/out sheets were incomplete. LPA discussed the sign in and out sheets with Director prior to her departure at 3:00PM. The inspection was continued with Lead Teacher Carissa Gonzales Angulo.

The following sign in/out sheets were incomplete:

3/2024, (15 days) child #3 was not signed out by parent/or staff when child was picked up by bus.
4/2024, (7 days) child #3 was not signed out by parent/staff responsible individual when child was picked up by bus.
4/18/2024, child #2 was not signed out by parent/or guardian.
7/12/2024, child #18 did not have parent/guardian signature/or time when child arrived.
7/12/2024, child #46 did not indicate the time the child was picked up by parent/guardian.


Based on observation, inspection and review of documents and interview revealed this facility is in violation of Child Care Regulations, Title 22, Division 12. 101229.1 (a)(1) & (b) Sign In and Sign Out the following Type B deficiency is cited on page 2.

An exit interview was conducted with Director. Director was provided and advised of Appeal Rights (LIC 9058). A copy of this report was reviewed and provided to the Licensee.

The Notice of Site Visit was also provided to the Director as required by H&S Code Section 1596.817.
The Notice of Site Visit must remain posted for 30 days or a civil penalty of $100.00 may apply.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Sylvia Ceja
LICENSING EVALUATOR SIGNATURE: DATE: 07/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/15/2024
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 07/15/2024 04:34 PM - It Cannot Be Edited


Created By: Sylvia Ceja On 07/15/2024 at 02:55 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
, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: VILLAGE VALLEY PRESCHOOL
FACILITY NUMBER: 426214409

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/15/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/22/2024
Section Cited
CCR
101229.1(a)(1)&b

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In addition to the sign-in procedure requirement of Section 101226.1(b), the licensee shall develop, maintain, and implement a written procedure to sign the child in/out of the child care center that shall, at a minimum, include the following:
(1) The person who signs the child in/out shall use his/her full legal signature and shall record the time of day. (b) The person who brings the child to, and removes the child from, the center shall sign the child in/out.
This requirement was not met by:
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Please submit a plan of correction to Licensing by 07/22/2024 to Licensing to ensure this violation is not repeated.
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Based on interviews with staff and record review: revealed 3/2024, (15 days)and 04/2024 (7 days) child #3 was not signed out by parent/staff or resonsible individual when child was picked up by bus. 4/18/2024, child #2 was not signed out by parent/guardian. 7/12/2024, child #18 did not have parent/guardian signature/or time when child arrived. Child #46 did not indicate the time the child was picked up by parent/guardian.
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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:Maria Mueller
LICENSING EVALUATOR NAME:Sylvia Ceja
LICENSING EVALUATOR SIGNATURE:
DATE: 07/15/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/15/2024


LIC809 (FAS) - (06/04)
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