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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426214409
Report Date: 03/14/2024
Date Signed: 03/14/2024 04:51:29 PM


Document Has Been Signed on 03/14/2024 04:51 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:MARIA E. ANGULOFACILITY TYPE:
850
ADDRESS:3346 CONSTELLATION ROADTELEPHONE:
8057337330
CITY:LOMPOCSTATE: CAZIP CODE:
93436
CAPACITY:32CENSUS: 27DATE:
03/14/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
10:06 AM
MET WITH:Carissa GonzalezTIME COMPLETED:
02:00 PM
NARRATIVE
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On 03/14/2024, at 10:06 AM, Licensing Program Analysts (LPAs) German Negrete and Sylvia Ceja made an unannounced inspection to the child care center. LPAs met with Carissa Gonzalez lead teacher of the Child Care Center (CCC). LPAs explained the nature of the inspection. LPAs observed 3 staff supervising 27 children.

LPAs toured the facility with the lead teacher. The staff #2 stated the facility currently had 25 children in the CCC. LPAs determined there were 27 children in care in the play ground with 3 staff providing care and supervision. At approximately 10:30am LPAs entered the classroom with staff# 2. LPAs and staff #2 observed child#1 unattended in the restroom who was washing his hands leaving the restroom. Staff #2 acknowledge they were unaware Child#1 was alone without supervision. During the inspection, LPAs observed staff#1 conducting housekeeping duties in the art room while children were not directly supervised while napping in the main room.

LPAs conducted a review of children and staff records. Child's records review revealed child #2 and child #4 were incomplete and child #3's file was missing. Staff qualifications and requirements were reviewed and are found to be in compliance.

During today's inspection, LPAs conducted interview with staff #2 stated there was a incident that occurred on 03/01/2024 regarding staff #4 who is no longer working at the center. The lead teacher was advised any type of Unusual Incident shall be reported to the Department for review.

Continued on 809-C
SUPERVISOR'S NAME: Ana TolentinoTELEPHONE: (805) 218-0429
LICENSING EVALUATOR NAME: German NegreteTELEPHONE: 805-315-8362
LICENSING EVALUATOR SIGNATURE:
DATE: 03/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/14/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 4


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		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 PRESCHOOL
FACILITY NUMBER: 426214409
VISIT DATE: 03/14/2024
NARRATIVE
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Also during the tour of the facility LPAs observed at least 4 children napping without sheets on their mats. LPAs advised director sheets are required.

LPAs observed children's jackets, personal belongings piled on top of a bench. LPAs did not observe appropriate storage/cubbies for children's personal belongings.

Deficiencies were cited under Title 22 Division 12. Please refer to LIC809D for documentation of deficiencies cited and a Technical Violation was issued.


Exit interview was conducted and report was reviewed with lead teacher. Notice of site visit was given and must remain posted for 30 days.


Failure to comply with posting requirements shall result in an immediate civil penalty of $100
SUPERVISOR'S NAME: Ana TolentinoTELEPHONE: (805) 218-0429
LICENSING EVALUATOR NAME: German NegreteTELEPHONE: 805-315-8362
LICENSING EVALUATOR SIGNATURE:

DATE: 03/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/14/2024
LIC809 (FAS) - (06/04)
Page: 4 of 4
Document Has Been Signed on 03/14/2024 04:51 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		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 PRESCHOOL
FACILITY NUMBER: 426214409

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/14/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/15/2024
Section Cited
CCR
101229(a)(1)

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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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Please submit a written plan by 03/15/2024 of how staff will meet the needs of the children. via email german.negrete@dss.ca.gov
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This requirement was not met due to LPAs and staff#2 observed child#1 unattended in the restroom. Staff #2 acknowledge they were unaware Child#1 was alone without supervision. LPAs observed staff#1 conducting housekeeping duties in the art room while children were not directly supervised while napping in the main room.
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Type B
03/22/2024
Section Cited
CCR101221(b)

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(b) Each record shall contain information including, but not limited to, the following:


This requirement was not met
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Please submit all complete files of the childrens records via email german.negrete@dss.ca.gov
by 03/22/2024
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 Child's records review revealed child #2 and child #4 were incomplete and child #3's file was missing. .
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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: Ana TolentinoTELEPHONE: (805) 218-0429
LICENSING EVALUATOR NAME: German NegreteTELEPHONE: 805-315-8362
LICENSING EVALUATOR SIGNATURE:
DATE: 03/14/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/14/2024
LIC809 (FAS) - (06/04)
Page: 2 of 4


Document Has Been Signed on 03/14/2024 04:51 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		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 PRESCHOOL
FACILITY NUMBER: 426214409

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/14/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/18/2024
Section Cited
CCR
101212(d)(1)

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d) Upon the occurrence, during the operation of the child care center of any of the events specified in (d)(1) below, a report shall be made to the Department by telephone or fax within the Department's next working day and during its normal business hours. In addition, a written report containing the information specified in (d)(2) below shall be submitted to the Department within seven days following the occurrence of such event.(1) Events reported shall include the following:
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Please submit a plan to ensure incidents are reported in a timely manner and submit incident report involving staff #4 by 03/18/2024 via email
german.negrete@dss.ca.gov
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This requirement was not met based on interview with the staff #1 who stated there was a incident that occurred on 03/01/2024 regarding staff #4 who is no longer working at the center.
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Type B
03/18/2024
Section Cited
CCR101238.4(a)

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The licensee shall ensure that each child has an individual permanent or portable storage space for his/her clothing, personal belongings and/or bedding....
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CCC will build or purchase cubbies and apropriate stoage equipment that will suffice the regulation. Director will submit photographs of the cubbies/ storage items via email to
german.negrete@dss.ca.gov

by 03/18/2024
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This requirement was not met as evidence by... LPAs observed children's jackets, personal belongings piled on top of a bench. LPAs did not observe appropriate storage/cubbies for children's personal belongings.
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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: Ana TolentinoTELEPHONE: (805) 218-0429
LICENSING EVALUATOR NAME: German NegreteTELEPHONE: 805-315-8362
LICENSING EVALUATOR SIGNATURE:
DATE: 03/14/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/14/2024
LIC809 (FAS) - (06/04)
Page: 3 of 4