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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566215423
Report Date: 07/11/2024
Date Signed: 07/11/2024 02:45:31 PM


Document Has Been Signed on 07/11/2024 02:45 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:MY DESTINY PRE-SCHOOL & CHILD CARE CENTER, INC.FACILITY NUMBER:
566215423
ADMINISTRATOR:YOLANDA ANN JACKSONFACILITY TYPE:
850
ADDRESS:53 MOODY COURTTELEPHONE:
(310) 462-6348
CITY:THOUSAND OAKSSTATE: CAZIP CODE:
91360
CAPACITY:15CENSUS: 17DATE:
07/11/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Yolanda Ann JacksonTIME COMPLETED:
03:00 PM
NARRATIVE
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On 07/11/2024, at approximately 9:30AM LPA's David Roman and Veronica Diaz conducted an unannounced visit at the facility for the purpose of closing out complaint investigations. Upon arrival, LPA's observed cooking/office assistant staff (S1) directly supervising preschool age children in the enclosed playground area. The observation lead LPA's in conducting a Case Management-Incident inspection.

The director, Yolanda Ann Jackson was not present during the inspection. Director arrived to the facility at approximately 9:45AM. LPA's informed the director, Yolanda Ann Jackson that the facility was out of compliance as S1 was directly supervising children. LPA's informed the director that Title 22 sections "101216.1(a-j) Teacher Qualifications and Duties" were not met as evidenced by the above information. Director, Yolanda Ann Jackson reported to understand the requirements for staff. LPA's informed the director of their appeal rights to advocate for themselves and their facility. The director reported that S1 is currently taking college courses to complete the Title 22 regulations. LPA's informed the director to provide proof of S1's college courses via transcript.

Exit interview and review of report was conducted with Director Yolanda Ann Jackson, Notice of Site visit was provided and must remain posted for the next 30 days.
SUPERVISOR'S NAME: George MingleTELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: David RomanTELEPHONE: (805) 562-0400
LICENSING EVALUATOR SIGNATURE:
DATE: 07/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/11/2024
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 07/11/2024 02:45 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: MY DESTINY PRE-SCHOOL & CHILD CARE CENTER, INC.
FACILITY NUMBER: 566215423

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/11/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/11/2024
Section Cited
CCR
101216.1(a-j)

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101216.1(a-j) Teacher Qualifications and Duties
(b) Prior to employment, a teacher shall meet the requirements of (b)(1) or (b)(2)
This requirements is not met as evidence by...
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Provide written format on how this requirement will be met. Provide proof of staff enrollment in classes.
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Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above in [count] out of [total count] [(objects) (persons)] [identifiers] which poses/posed a potential health, safety, or personal rights risk to persons 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 MingleTELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: David RomanTELEPHONE: (805) 562-0400
LICENSING EVALUATOR SIGNATURE:
DATE: 07/11/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/11/2024
LIC809 (FAS) - (06/04)
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