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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197750097
Report Date: 02/09/2023
Date Signed: 02/09/2023 04:41:31 PM

Document Has Been Signed on 02/09/2023 04:41 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:
197750097
ADMINISTRATOR:PARAG LADDHAFACILITY TYPE:
850
ADDRESS:24615 COPPER HILL DRIVETELEPHONE:
(661) 904-9530
CITY:SANTA CLARITASTATE: CAZIP CODE:
91354
CAPACITY: 132TOTAL ENROLLED CHILDREN: 132CENSUS: 119DATE:
02/09/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
04:23 PM
MET WITH:Sarah Mitchell, DirectorTIME COMPLETED:
04:50 PM
NARRATIVE
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On 02/09/23, Licensing Program Analyst (LPA) Justeene Tamayo conducted a Case Management inspection at the above facility. LPA met with Director Sarah. Upon initial walk through, LPA observed 119 preschool children in care, along with 16 staff and the Director. LPA observed 2 uncleared adults (staff #1 and staff #2) in the center providing care to children. LPA observed staff #1 and staff #2 leave the facility due being uncleared. Director is aware that all adults 18 and over must be fingerprint cleared and associated before assisting with children.

The Facility has been cited a Type A deficiency according to the California Code of Regulations of Title 22 . Please see Facility Evaluation Report 809-D for deficiencies.

Upon receipt of a Type A deficiency licensee shall post the report for 30 days in addition to the Notice of Site Visit and provide copies of the licensing report to parents/guardians of children in care at the facility. This report must be provided to parents/guardians of children newly enrolled at the facility during the next 12 months and licensee will obtain a signed acknowledgment of Licensing Reports (LIC9224) from parent/guardian and place it in each child's file. If these requirements are not met, civil penalties will be assessed.

An exit interview was conducted with Director, a copy of this report was read, discussed and provided to Director, along with the appeal rights and notice of site visit.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE: DATE: 02/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/09/2023
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 02/09/2023 04:41 PM - It Cannot Be Edited


Created By: Justeene Tamayo On 02/09/2023 at 04:29 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
, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: LEARNING EXPERIENCE, THE
FACILITY NUMBER: 197750097

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/09/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Deficiency Dismissed
Type A
02/09/2023
Section Cited
CCR
101170(a)

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101170 Criminal Record Clearance (a) The Department shall conduct a criminal record review of all persons specified in Health and Safety Code Section 1596.871(b).The Department has the authority to approve or deny...employment, residence or presence in the facility...This requirement is not met as evidenced by:
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Per licensee the Staff #1 and staff #2 will not be allowed to work at the facility until the staff members are fingerprint cleared and associated to the facility.
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Based on observation Staff #1 and staff #2 does not have proof of fingerprint clearance, which poses an immediate Health, Safety or Personal Rights risk to children 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:Mariela Ramon
LICENSING EVALUATOR NAME:Justeene Tamayo
LICENSING EVALUATOR SIGNATURE:
DATE: 02/09/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/09/2023


LIC809 (FAS) - (06/04)
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