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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426214409
Report Date: 04/10/2024
Date Signed: 04/10/2024 11:39:02 AM


Document Has Been Signed on 04/10/2024 11:39 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
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:
(805) 733-7330
CITY:LOMPOCSTATE: CAZIP CODE:
93436
CAPACITY:32CENSUS: 28DATE:
04/10/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Angulo Maria ElenaTIME COMPLETED:
12:00 PM
NARRATIVE
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On 4/10/2024, Licensing Program Analyst (LPA) German Negrete conducted an unannounced Case Management - Deficiencies inspection, in orderto complete the inspection conducted on 3/14/2024. Today LPA met with , Director Angulo Maria E. and explained the purpose of the inspection which was to complete the inspection from 3/14/2024.

On 3/14/2024 LPAs (German Negrete) (Sylvia Ceja) observed 3 staff supervising 27 children at the start of the inspection. At about 11:55 am LPA's observed another child(C5) that was not part of the original count playing in the out side play yard. This brought the count to 28 children. During the inspection LPAs verified that C5 did not have record or documentation of being enrolled at the center. At 2:50pm the inspection on 3/14/2024 ended.

In the following days , LPA (German Negrete) discovered that C5 was actually the grandchild of the center Director. Also in the following days LPA verified that C5 is not a child but a infant. This information was verified through staff interviews and emails with the center Director.


At the time of the inspection on 3/14/2024, the Director, was cited 4 type B deficiencies(see LIC809-D) and today, LPA will cite a 5th type B deficiency under Title 22 division 12 Article 2 (101161(a)) Limitations on Capacity.
This Report Continues LIC 809D
SUPERVISOR'S NAME: Ana TolentinoTELEPHONE: (805) 218-0429
LICENSING EVALUATOR NAME: German NegreteTELEPHONE: 805-315-8362
LICENSING EVALUATOR SIGNATURE:
DATE: 04/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/10/2024
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 04/10/2024 11:39 AM - 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: 04/10/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/24/2024
Section Cited
CCR
101161(a)

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a) A licensee shall not operate a child care center beyond the conditions and limitations specified on the license, including the capacity limitation.
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Director will read title 22 CCR 101161(a) and email any questions to LPA pertaining to this regulation. If the director has no questions then the drirector will email LPA stating she fully understand the regulation.
german.negrete@dss.ca.gov
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This requirement was not met due to LPA conducting staff and director interviews pertaining to(C5) enrollement, file records, and emails with director verifying that C5 is an infant and should not be enrolled or be receiving care and supervision at this facility.
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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: 04/10/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/10/2024
LIC809 (FAS) - (06/04)
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