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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 485407833
Report Date: 04/25/2022
Date Signed: 04/25/2022 02:13:40 PM

Document Has Been Signed on 04/25/2022 02:13 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, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME:LEARNING EXPERIENCE-PRESCHOOL, THEFACILITY NUMBER:
485407833
ADMINISTRATOR:OLDANI, SABRINAFACILITY TYPE:
850
ADDRESS:1959 PEABODY ROADTELEPHONE:
(707) 305-4336
CITY:VACAVILLESTATE: CAZIP CODE:
95688
CAPACITY: 120TOTAL ENROLLED CHILDREN: 120CENSUS: 40DATE:
04/25/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Director, Jennifer HansenTIME COMPLETED:
10:15 AM
NARRATIVE
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An unannounced case management inspection was conducted by Licensing Program Analyst (LPA) Wisehart who met with Director, Jennifer Hansen to discuss revise a report done on 3/25/22 to amend the civil penalty.. The report was for an incident which occurred on 3/22/22. The LPA conducted interviews and toured the facility.

The Licensee stated that on 3/22/22 at 11 am, a classroom was transitioning from outdoor play back into the classroom. Inside the buildings hallway, teacher (S1) was doing a name to face head count standing with the door open, letting children in one by one when (C1) after being counted, slipped back out the door and was found 1 to 3 minutes later standing in front of the child's classroom door.

This incident constitutes a lack of supervision. The incident was reported to CCL within 24 hours or the next business day, as required.

The Licensee stated that on 3/22/22, she reviewed with staff the importance of name to face counts and to check hallways before closing the door; Licensee also sent out a communication letter to staff as a reminder which was signed by staff and each classroom has listed safety habits in the classroom to remind staff.

The LPA printed and reviewed the documents needed for Director changes and Teacher Aide Qualifications and Duties (Reg 101216.2) with the Licensee.

The following violation of the CA Code of Regulations, Title 22; Division 12 or Health and Safety Code, were observed: see LIC 809D. This report was reviewed with the Licensee/Director and appeal rights were provided. This was a second citation within a 12 month period resulting in a Civil Penalty being issued.
SUPERVISORS NAME: Megan Aviles
LICENSING EVALUATOR NAME: Carrie Wisehart
LICENSING EVALUATOR SIGNATURE: DATE: 04/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/25/2022
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 04/25/2022 02:13 PM - It Cannot Be Edited


Created By: Carrie Wisehart On 04/25/2022 at 06:46 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
, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME: LEARNING EXPERIENCE-PRESCHOOL, THE
FACILITY NUMBER: 485407833

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/25/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/02/2022
Section Cited
CCR
101229(a)(1)

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 Responsibility for Providing Care and Supervision 101229(a)(1) The licensee shall provide care and supervision as necessary to meet the children's needs. (1) No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation
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The license held a staff meeting and reviewed the importance of name to face counts and checking hallways. The Licensee will also have staff watch the childcare videos on Supervision in a Child Care Center. The Licensee will then send to CCL the names of staff who watched the videos; dates of training and topics covered by 5/2/22.
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This requirement was not met as evidenced by: Based on interviews and record review, C1 was unsupervised for 1-3 minutes after slipping out of the classroom during name to face head counts into a hallway, during transition back into the classroom from outdoor play.This poses a potential health, safety or personal rights risk to persons in care.
This is a repeat citation within 12 months, resulting in the issuance of a Civil Penalty.
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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:Megan Aviles
LICENSING EVALUATOR NAME:Carrie Wisehart
LICENSING EVALUATOR SIGNATURE:
DATE: 04/25/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/25/2022


LIC809 (FAS) - (06/04)
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