Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426214409
Report Date: 11/08/2019
Date Signed: 11/08/2019 02:37:34 PM

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:VILLAGE VALLEY PRESCHOOLFACILITY NUMBER:
426214409
ADMINISTRATOR:MARIA E. ANGULOFACILITY TYPE:
850
ADDRESS:3346 CONSTELLATION ROADTELEPHONE:
(805) 733-7330
CITY:LOMPOCSTATE: CAZIP CODE:
93436
CAPACITY:26CENSUS: 23DATE:
11/08/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Maria AnguloTIME COMPLETED:
02:45 PM
NARRATIVE
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An annual random/increase of capacity inspection was conducted by LPA S. Mendoza-Ceja who met with Director Maria Angulo. The Director requested an increase of capacity for 33 children. The center was toured inside and outside. The preschool operates Monday - Friday, 7:45 AM - 5:00 PM. The Director stated there are no bodies of water or firearms on the premises. LPA did not observe any bodies of water. LPA discussed medication. The Director stated they encourage parents to administer medication at home. Medication is not administered at the preschool. The classrooms were observed to be clean and orderly. The appropriate documents including the menu were posted. LPA reviewed the handout “A Child Care Provider’s Guide to Safe Sleep, Safe Sleep and Effects of Lead Exposure”. There is carbon monoxide detector in the center was tested. The restrooms were observed to clean. The outside playground equipment was observed to be age appropriate. A random review was conducted of children's records for emergency contact information. Staff records were reviewed. LPA reviewed current CPR and First Aid for two staff. LPA reviewed the requirement for care providers/employees, including volunteers to obtain immunization against Influenza, Pertussis, and Measles. LPA reviewed verification of immunization for staff. LPA also advised, each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year or obtain a sign statement declining the influenza vaccination. LPA also reviewed certificate of completion of the AB 1207 Child Abuse Mandated Reporter Training for Director. Verification was not available for staff #2 and #4.
SUPERVISOR'S NAME: Ana TolentinoTELEPHONE: (805) 562-0437
LICENSING EVALUATOR NAME: Sylvia Mendoza-CejaTELEPHONE: (805) 722-5132
LICENSING EVALUATOR SIGNATURE:

DATE: 11/08/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2019
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: VILLAGE VALLEY PRESCHOOL
FACILITY NUMBER: 426214409
VISIT DATE: 11/08/2019
NARRATIVE
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In addition, LPA re-evaluated the center for the increase of capacity which included measuring classroom #3 and the outdoor square footage.

Indoor Square Footage meets the requirement for 32 children.
Outdoor Square Footage exceeds the requirement for 33 children.
There are three sinks and three toilets which exceeds the requirement 33.
There is shade available outside.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

The following Type B deficiency is cited according to CCR, Title 22, Division 12, on 809d in regards to AB 1207 Child Abuse Mandated Reporter Training for staff #2 and #4. Appeal Rights were provided. An exit interview was conducted with the Director and a plan of correction was developed.

Prior to the increase of capacity the following will need to be completed:
1. Fire Clearance granted and reviewed by the Department.

The Notice of Site Visit was posted at the visit.

SUPERVISOR'S NAME: Ana TolentinoTELEPHONE: (805) 562-0437
LICENSING EVALUATOR NAME: Sylvia Mendoza-CejaTELEPHONE: (805) 722-5132
LICENSING EVALUATOR SIGNATURE:

DATE: 11/08/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2019
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: VILLAGE VALLEY PRESCHOOL
FACILITY NUMBER: 426214409
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/08/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/25/2019
Section Cited

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Health and Safety - Child Abuse Mandated Reporter Training: On or before March 30, 2018,...is a licensed child care provider, ...employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.
This requirement was not met as evidenced by:



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Licensee's failure to ensure that staff #2 and #4 have not completed the training which poses a potential health and safety risk to 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: Ana TolentinoTELEPHONE: (805) 562-0437
LICENSING EVALUATOR NAME: Sylvia Mendoza-CejaTELEPHONE: (805) 722-5132
LICENSING EVALUATOR SIGNATURE:
DATE: 11/08/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/08/2019
LIC809 (FAS) - (06/04)
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