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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566212345
Report Date: 09/28/2021
Date Signed: 09/28/2021 04:47:56 PM

Document Has Been Signed on 09/28/2021 04:47 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, 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: 138CENSUS: 46DATE:
09/28/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Heather ShieldsTIME COMPLETED:
03:15 PM
NARRATIVE
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On September 28, 2021 at 1:45 PM, Licensing Program Analyst (LPA) Francisco Pedroza conducted an unannounced Case Management inspection. LPA met with Assistant Director Heather Shields and advised her the purpose of the inspection. Assistant Director provided LPA a tour of the facility. There was 46 children in care at the time of the inspection.

On July 30, 2021, LPA Pedroza conducted a case management inspection regarding an incident where a parent observed via video a facility staff forcing a child to lay down during quiet time. The incident was reported to the facility headquarters whom contacted the local District Manager (DM) Katherine Stevens. DM reviewed the video footage of the incident and contacted the facility Director Valerie Lopez to advise her of the incident and to place the teacher on administrative leave. The staff's employment with the company was discontinued later that evening. Director contacted Community Care Licensing (CCL) and reported the incident. LPA requested to the review the video from the DM so LPA can determine the outcome of the incident at a later time.

LPA reviewed the video and observed that S4 was sitting with a child during what appeared to be quiet time. The child was refusing to lay down like the other children in the classroom. During the video LPA observed S4 guide the child's head down to lay down with her hand. The child sat back up on their knees. Shortly after LPA observed S4 again guide the child's head back down on the mat with their hand. At this time S4 additionally pulled the child's legs out forcing them to lay down. The child then immediately sat back up on their knees.

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SUPERVISORS NAME: George Mingle
LICENSING EVALUATOR NAME: Francisco Pedroza
LICENSING EVALUATOR SIGNATURE: DATE: 09/28/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/28/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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: 09/28/2021
NARRATIVE
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LPA conducted parent and staff interviews. LPA did not gather more information or evidence with the interviews to confirm if this was an isolated incident or occurred more than once. After reviewing the incident on video, LPA determined that the incident was true and did occur. Given the facility's account of the incident when reporting it to CCL and how they addressed the incident, LPA deemed the facility's action was appropriate. The facility acknowledged they are being transparent and ensuring the safety of the children in their care.

The following CCR, Title 22, Division 12 regulation was cited: 101223(a)(3) Personal Rights.

Assistant Director was provided a copy of the regulation and advised of their right to appeal. A copy of their appeal rights was provided.

One type B deficiency was cited during today's inspection.

THE NOTICE OF SITE VISIT WAS POSTED AS REQUIRED BY H&S CODE SEC. 1596.817. THE NOTICE OF SITE VISIT MUST REMAIN POSTED FOR 30 DAYS OR A CIVIL PENALTY OF $100.00 WILL APPLY.
SUPERVISORS NAME: George Mingle
LICENSING EVALUATOR NAME: Francisco Pedroza
LICENSING EVALUATOR SIGNATURE:

DATE: 09/28/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2021
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Document Has Been Signed on 09/28/2021 04:47 PM - It Cannot Be Edited


Created By: Francisco Pedroza On 09/28/2021 at 03:47 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: 09/28/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/11/2021
Section Cited
CCR
101223(a)(3)

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101223 Personal Rights
(a) The licensee shall ensure that each child is accorded the following personal rights:
(3) To be free from corporal or unusual punishment, infliction of pain, humiliation,...or aids to physical functioning.
This requirement is not met as evidence by:
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Director will submit a written plan of correction stating measures to be taken in order to be in compliance with Title 22 Regulations and avoid any Personal Rights violations by 10/11/2021 via fax (805) 685-1820 or email to francisco.pedroza@dss.ca.gov
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Teacher was observed guiding a child's head down and pulling their legs outward forcing them to lay down on the mat. Teacher's employment was discontinued. This poses as a potential Health and Safety risk to clients / 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:George Mingle
LICENSING EVALUATOR NAME:Francisco Pedroza
LICENSING EVALUATOR SIGNATURE:
DATE: 09/28/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/28/2021


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