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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197750096
Report Date: 02/02/2022
Date Signed: 02/02/2022 02:17:21 PM

Document Has Been Signed on 02/02/2022 02:17 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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:LEARNING EXPERIENCE, THEFACILITY NUMBER:
197750096
ADMINISTRATOR:PARAG LADDHAFACILITY TYPE:
830
ADDRESS:24615 COPPER HILL DRIVETELEPHONE:
(661) 904-9530
CITY:SANTA CLARITASTATE: CAZIP CODE:
91354
CAPACITY: 32TOTAL ENROLLED CHILDREN: 32CENSUS: 11DATE:
02/02/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
01:40 PM
MET WITH:Samantha Scalise, Director TIME COMPLETED:
02:43 PM
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Licensing Program Analysts' (LPA) Maddox and Ayala met with Samantha Scalise, Director today for the purpose of conducting an unannounced Case Management inspection to decrease the capacity from 32 to 20. Center is requesting to add the capacity 12 to their Pre-school license.

Director guided Analyst(s) on a tour of the Infant Room and observed 3 infants present (1 asleep). Director is aware of the updated Safe sleep regulations and aware of LIC 9227. Staff are also checking on Infants ever 15 minutes. There were no barriers to prevent staff from having visual observation of Infants as they sleep.

There is a refrigerator in the classroom with individual trays labeled with Infants names.

Exit interview conduced, copy of this report was left with Director, after it was reviewed and signed.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE: DATE: 02/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/02/2022
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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