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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073408263
Report Date: 02/04/2022
Date Signed: 02/04/2022 02:01:17 PM

Document Has Been Signed on 02/04/2022 02:01 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, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:LEARNING EXPERIENCE, THEFACILITY NUMBER:
073408263
ADMINISTRATOR:ROBYN KINGFACILITY TYPE:
850
ADDRESS:4831 LONE TREE WAYTELEPHONE:
(925) 281-7640
CITY:ANTIOCHSTATE: CAZIP CODE:
94531
CAPACITY: 130TOTAL ENROLLED CHILDREN: 130CENSUS: 39DATE:
02/04/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:TANYA ARCHERTIME COMPLETED:
02:00 PM
NARRATIVE
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11:30AM- LICENSING PROGRAM ANALYST ALEXANDER MET WITH CENTER DIRECTOR TODAY TO DISCUSS COMPLAINT ALLEGATIONS. DURING TODAY'S VISIT IT WAS DISCOVERED IN THE "PREPPERS" ROOM THERE WAS 9 PRESCHOOL AGE CHILDREN ALONG WITH 2 AIDS.

PLEASE SEE THE ATTACHED 809-D FOR CITATION
SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Tasha Hackett-Alexander
LICENSING EVALUATOR SIGNATURE: DATE: 02/04/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/04/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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Document Has Been Signed on 02/04/2022 02:01 PM - It Cannot Be Edited


Created By: Tasha Hackett-Alexander On 02/04/2022 at 01:42 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
, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: LEARNING EXPERIENCE, THE
FACILITY NUMBER: 073408263

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/04/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/07/2022
Section Cited
CCR
101216.3(a)

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101216.3 Teacher-Child Ratio
(a) There shall be a ratio of one teacher visually observing and supervising no more than 12 children in attendance,
REQUREMENT WAS NOT MET:
TODAY IN THE PREPPERS ROOM, THERE ARE 2 AIDS SUPERVISING 9 PRESCHOOL AGE CHILDREN.
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CORRECTED DURING INSPECTION.
A FULLY QUALIFIED TEACHER WAS MOVED INTO THE ROOM AND ONE OF THE AIDS WAS MOVED INTO ANOTHER ROOM TO ASSIST ANOTHER FULLY QUALIFIED TEACHER.

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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:Loretta Dyson
LICENSING EVALUATOR NAME:Tasha Hackett-Alexander
LICENSING EVALUATOR SIGNATURE:
DATE: 02/04/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/04/2022


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