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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566212345
Report Date: 04/08/2022
Date Signed: 04/08/2022 10:11:50 AM

Document Has Been Signed on 04/08/2022 10:11 AM - 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, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:TUTOR TIME CHILD CARE/LEARNING CENTER SVFACILITY NUMBER:
566212345
ADMINISTRATOR:VALERIE LOPEZFACILITY TYPE:
850
ADDRESS:1080 COUNTRY CLUB DRIVE WESTTELEPHONE:
(805) 582-0562
CITY:SIMI VALLEYSTATE: CAZIP CODE:
93065
CAPACITY: 138TOTAL ENROLLED CHILDREN: 85CENSUS: 52DATE:
04/08/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:05 AM
MET WITH:Valerie LopezTIME COMPLETED:
10:30 AM
NARRATIVE
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On April 8, 2022 at 9:05 AM, Licensing Program Analyst (LPA) Dean Thompson conducted an unannounced Case Management- Incident inspection. LPA met with facility Director Valerie Lopez and advised her the purpose of the inspection. Covid pre-screening questions were asked to make sure no one inside has tested positive for COVID or have any flu like symptoms. Director provided LPA a tour of the facility. There were 52 children in care at the time of the inspection.

Child Care Licensing (CCL) was provided the wrong license number for the incident reported to CCL on 3/17/2022 by Director Valerie Lopez. A report was conducted on license number 566212347 and has since been amended. LPA Thompson conducted the inspection on 3/18/2022.

On March 18, 2022 at 9:10 AM, Licensing Program Analyst (LPA) Dean Thompson conducted an unannounced Case Management- Incident inspection. LPA met with facility assistant Director Heather Shields and advised her the purpose of the inspection. Covid pre-screening questions were asked to make sure no one inside has tested positive for COVID or have any flu like symptoms. Director provided LPA a tour of the facility. There were 19 children in care at the time of the inspection inside the Pre-K classroom with one staff.

On 3/17/2022, Director V. Lopez contacted Community Care Licensing (CCL) to self-report an incident of a day care child being left unattended in the Pre-K classroom for five (5) minutes. Staff (S1) was unaware the child went to the restroom as the children were going outside.

LPA requested video footage but was unable to obtain the video at the time of inspection.

Continued on LIC 809-C

SUPERVISORS NAME: George Mingle
LICENSING EVALUATOR NAME: Dean Thompson
LICENSING EVALUATOR SIGNATURE: DATE: 04/05/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/05/2022
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: TUTOR TIME CHILD CARE/LEARNING CENTER SV
FACILITY NUMBER: 566212345
VISIT DATE: 04/08/2022
NARRATIVE
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On 3/18/2022 at or around 11:30 AM, LPA Thompson interviewed assistant Director Heather Shields and other staff members regarding the incident.

Staff interviews were conducted on March 18, 2022 and was determined C1 was left inside the classroom unattended for approximately five minutes. It was determined by staff interviews, when C1 was found inside the classroom, C1 was in distress and looked scared.



LPA reviewed S1 file and it was determined that S1 was issued a final written warning noticed on March 17, 2022 for child supervision and face to name under the facilities policy and /or procedure violation.

Based on LPA observations and interviews which were conducted and record review(s), the preponderance of evidence standard has been met, therefore the above allegation(s) is found to be SUBSTANTIATED. California Code of Regulations, (Title 22, Division & Chapter number), are being cited on the attached LIC 809 D.

Training video - https://ccld.childcarevideos.org/



LPA Thompson informed assistant director Heather Shields that this report dated March 18, 2022 document(s) one (1) of Type B citation.



Notice of Site Visit

A notice of site visit was given and must remain posted for 30 days.

Posting Requirements

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit Interview

Exit interview conducted and report was reviewed with the assistant director Heather Shields.

SUPERVISORS NAME: George Mingle
LICENSING EVALUATOR NAME: Dean Thompson
LICENSING EVALUATOR SIGNATURE:

DATE: 04/05/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/05/2022
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Document Has Been Signed on 04/08/2022 10:11 AM - It Cannot Be Edited


Created By: Dean Thompson On 04/05/2022 at 12:42 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: TUTOR TIME CHILD CARE/LEARNING CENTER SV
FACILITY NUMBER: 566212345

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/08/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/01/2022
Section Cited
CCR
101229(a)(1)

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Responsibility for Providing Care and Supervision
(a) 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.

This requirement is not met as evidenced by:
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Assistant director agreed submit a written plan of correction (POC) stating measures to be taken in order to follow Title 22 Regulations and avoid another incident like this happening in the future. Licensee provided training video resource https://ccld.childcarevideos.org/for staff to view and provide what they learned. POC is due to CCLD by 4/1/2022.
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Based on staff interview and record review, C1 was left unattended inside the Pre-k classroom for approximately for five (5) minutes and was found in distress, which poses an immediate health, safety or personal rights risk to persons in care.
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In addition to the wriiten plan, an informal conference was completed on 4/4/2022 and the written Plan of Correction was received on March 28, 2022

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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:George Mingle
LICENSING EVALUATOR NAME:Dean Thompson
LICENSING EVALUATOR SIGNATURE:
DATE: 04/05/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/05/2022


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