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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 196216377
Report Date: 09/15/2022
Date Signed: 10/06/2022 01:29:46 PM

Document Has Been Signed on 10/06/2022 01:29 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, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:KNOLLS LEARNING STUDIO, THEFACILITY NUMBER:
196216377
ADMINISTRATOR:TRESSA MENDOZAFACILITY TYPE:
850
ADDRESS:28348 AGOURA ROADTELEPHONE:
(818) 991-7752
CITY:AGOURA HILLSSTATE: CAZIP CODE:
91301
CAPACITY: 22TOTAL ENROLLED CHILDREN: 22CENSUS: 0DATE:
09/15/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:TRESSA MENDOZATIME COMPLETED:
01:27 PM
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THIS IS AN AMENDMENT OF REPORT ISSUED ON 9/15/2022 to change capacity.

On 10/6/22 at 12:46PM, Licensing Program Analysts (LPA) Michael Mathew, Susana Martinez and Licensing Program Manger (LPM) George Mingle conducted an announced Pre licensing inspection. Prior to entering the facility, LPA met with applicant Tressa Mendoza and conducted a COVID-19 risk assessment. All answers indicated no exposure to COVID-19. LPA discussed the nature and purpose of the inspection. Adults in the Childcare center have obtained a criminal background clearance. Applicant, LPAs and LPM toured the facility inside and outside.
The preschool program uses classrooms 2 and 4. There is a infant component located at the same address 196216378. A fire clearance was granted by Los Angeles County Fire Department (LACFD) on 9/1/2022. Classroom 2 has a total capacity of 13 children and classroom 4 which has a total capacity of 8 children. . LPA observed required licensing documents mounted on the walls throughout the facility. LPA observed the center menu posted. This facility will be providing morning and afternoon snack and Parents will be bringing lunch. LPA observed baby gates preventing the children from coming down the stairs. LPA observed a total of 2 sinks with 3 toilets for children in care. LPA did not observe any hazards/toxins items accessible to children. There are no guns/weapons or ammunition at the facility. LPA observed no bodies of water. Each of the classrooms have age-appropriate toys and furniture readily accessible for children. Facility will be providing children sleeping cots during nap time. The outdoor playground has ample amount of space for capacity requested. LPA observed the playground has age-appropriate toys and structures available for children to use. LPA observed sand under the play structure to help protect the children when they fall. The playground has an ample amount of shade available. Facility will be providing water pitchers, and the children will have water bottles with their names on it for use, facility will also provide cup for those child who does not have a water bottle. Ms. Tressa stated she filters waters from the facility for the children. Ms. Tressa was informed of lead testing and was provided a copy for PIN21-21CCP, Lead testing in CCC frequently asked question and PIN 20-01-CCP. LPA observed carbon monoxide detectors in both Preschool classrooms to be good and in working condition. Cont 809-C
SUPERVISORS NAME: George Mingle
LICENSING EVALUATOR NAME: Michael Mathew
LICENSING EVALUATOR SIGNATURE: DATE: 10/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/06/2022
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: KNOLLS LEARNING STUDIO, THE
FACILITY NUMBER: 196216377
VISIT DATE: 09/15/2022
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LPA provided and reviewed with applicant the LIC 311A, Records To Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted. LPA discussed information capacity, ratios, current Covid-19, and safe sleep requirements. Applicant was made aware that it is the facility's responsibility to know the current regulations for a CCC which can be accessed on-line at www.cdss.ca.gov.

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 follow 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

Director was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

The center meets Title 22 Division 12 requirements. License will be effective today, 10/6/2022 for total capacity of 21 preschool children.

Exit interview conducted, appeal rights were given, and report was reviewed with the Applicant.

SUPERVISORS NAME: George Mingle
LICENSING EVALUATOR NAME: Michael Mathew
LICENSING EVALUATOR SIGNATURE:

DATE: 09/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2022
LIC809 (FAS) - (06/04)
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