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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334842315
Report Date: 01/20/2022
Date Signed: 01/20/2022 02:33:07 PM

Document Has Been Signed on 01/20/2022 02:33 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, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:LEARNING EXPERIENCE, THEFACILITY NUMBER:
334842315
ADMINISTRATOR:MICHELLE SOLORIOFACILITY TYPE:
850
ADDRESS:12754 LIMONITE AVENUETELEPHONE:
(951) 817-8817
CITY:EASTVALESTATE: CAZIP CODE:
92880
CAPACITY: 193TOTAL ENROLLED CHILDREN: 180CENSUS: 89DATE:
01/20/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
08:35 AM
MET WITH:Michelle SolorioTIME COMPLETED:
02:45 PM
NARRATIVE
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On 1/20/2022, Licensing Program Analyst (LPA) Samuel Lopez arrived at the facility to conduct an inspection regarding an issue unrelated to the deficiencies addressed/observed today. LPA Lopez toured the facility, conducted a census, and was checking associations of staff present at the facility. While checking associations, LPA Lopez discovered that one staff member's did not appear on the facility's associations list. While at the facility, LPA Lopez conducted a search based on the facility and staff's information. LPA Lopez discovered that the staff member had been disassociated in May 2020.

Also addressed during today's inspection was the receipt of (2) Unusual Incident Reports (UIR). The reason they were address was because the facility failed to submit them within the required time frame (next working/business day). According to the reports the incidents had occurred on 1/12/2022 and they were submitted, via email, on 1/15/2022.

Based on the information above, the facility is found to be in violation of Title 22 regulations.

A Civil Penalty has been assessed during this inspection. Payment is due when billed and the check(s) or money orders shall be made payable to the “California Department of Social Services”. YOU WILL RECEIVE AN INVOICE IN THE MAIL. DO NOT SEND MONEY UNTIL YOU RECEIVE YOUR INVOICE. DO NOT SEND CASH.

See LIC809-D for cited deficiencies.

LPA Samuel Lopez informed Director Michelle that this report dated January 20, 2022 document(s) (1) Type A citation, which shall be posted for 30 consecutive days as there is an immediate risk to the health, safety, or personal rights of children in care.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Samuel Lopez
LICENSING EVALUATOR SIGNATURE: DATE: 01/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/20/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: LEARNING EXPERIENCE, THE
FACILITY NUMBER: 334842315
VISIT DATE: 01/20/2022
NARRATIVE
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Also, LPA Samuel Lopez informed the Director Michelle Solorio to provide a copy of this licensing report dated January 20, 2022 that documents any Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

Exit interview conducted and report was reviewed with the Director Michelle Solorio.

A notice of site visit was given and must remain posted for 30 days.

SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Samuel Lopez
LICENSING EVALUATOR SIGNATURE:

DATE: 01/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/20/2022
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 01/20/2022 02:33 PM - It Cannot Be Edited


Created By: Samuel Lopez On 01/20/2022 at 01:12 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
, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: LEARNING EXPERIENCE, THE
FACILITY NUMBER: 334842315

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/20/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/27/2022
Section Cited
CCR
101212(d)

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Reporting Requirements: Upon the occurrence, during the operation of the child care center of any of the events specified in (d)(1) below, a report shall be made to the Department by telephone or fax within the Department's next working day and during its normal business hours. This requirement was not being met as evidenced by the receipt
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Facility representative agrees to submit a written statement regarding the plan to assure Incident Reports are submitted timely, as required by the cited regulation section. Plan to be submitted to the Riverside Child Care Regional Office by 1/27/2022.
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of the incident reports, which was, 3 days after their occurrence, and knowledge of them occurring. This poses a potential risk to the Health and Safety of 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:Aaron Ross
LICENSING EVALUATOR NAME:Samuel Lopez
LICENSING EVALUATOR SIGNATURE:
DATE: 01/20/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/20/2022


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 01/20/2022 02:33 PM - It Cannot Be Edited


Created By: Samuel Lopez On 01/20/2022 at 01:24 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
, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: LEARNING EXPERIENCE, THE
FACILITY NUMBER: 334842315

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/20/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
01/21/2022
Section Cited
CCR
101170(e)(2)

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Criminal Record Clearance: All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility: Request a transfer of a criminal record clearance as specified in Section 101170(f). This requirement was not being met as evidenced by a staff member
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The staff member was excused from the facility. The facility representative agrees to submit the required documentation to have the staff member associated to the facility. Documentation to be submitted to the Riverside Child Care Regional office by 1/21/2022.
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being present, at the facility, without a criminal record clearance or associated to the facility license. This poses an immediate risk to the Health and Safety, Personal Right of the children in care.

A $500.00 civil penalty was also issued with this citation.
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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:Aaron Ross
LICENSING EVALUATOR NAME:Samuel Lopez
LICENSING EVALUATOR SIGNATURE:
DATE: 01/20/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/20/2022


LIC809 (FAS) - (06/04)
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