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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 483008079
Report Date: 10/02/2024
Date Signed: 10/02/2024 03:53:31 PM

Document Has Been Signed on 10/02/2024 03:53 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, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME:WORLD CHANGERS ACADEMY (PS)FACILITY NUMBER:
483008079
ADMINISTRATOR/
DIRECTOR:		MEJIA, ERICAFACILITY TYPE:
850
ADDRESS:470 EAST H STREETTELEPHONE:
(707) 365-5639
CITY:DIXONSTATE: CAZIP CODE:
95620
CAPACITY: 30TOTAL ENROLLED CHILDREN: 30CENSUS: 36DATE:
10/02/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:Erica MejiaTIME VISIT/
INSPECTION COMPLETED:
04:00 PM
NARRATIVE
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On 10/2/2024 at 10:20am, an inspection was made to the facility by Licensing Program Analyst (LPA) Laura Chavez. Upon arrival to the facility LPA observed S1 in the sanctuary alone caring for 25 children. Three toddlers ages 18 months, 25 months, and 34 months, enrolled in the toddler component were observed co-mingling with preschool age children.
During today’s inspection, the facility was toured. LPA observed S2 and S3 caring for 11 additional preschool age children in the preschool classroom. A review of staff records found S1, S2, and S3 do not have the units required to be considered qualified teachers.

Based on LPA's observations the following deficiencies are being cited on the LIC809-D: 101161(a) - Limitations on capacity, 101216.3(a) - Teacher-Child Ratio, and 101216.4(a)(2) - Preschool Program with Toddler Component.

LPA Laura Chavez informed Erica Mejia, Director that this report dated 10/2/2024 documents 3 Type A citations 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.

Report continued: See LIC809-C
SUPERVISORS NAME: Megan Aviles
LICENSING EVALUATOR NAME: Laura Chavez
LICENSING EVALUATOR SIGNATURE: DATE: 10/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/02/2024
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 10/02/2024 03:53 PM - It Cannot Be Edited


Created By: Laura Chavez On 10/02/2024 at 02:15 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
, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME: WORLD CHANGERS ACADEMY (PS)
FACILITY NUMBER: 483008079

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/02/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/03/2024
Section Cited
CCR
101161(a)

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Limitations on Capacity - A licensee shall not operate a child care center beyond the conditions and limitations specified on the license, including the capacity limitation.
Based on LPA's observation, the licensee did not comply with the section cited above. LPA observed 36 children in care.
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The Director agrees to provide a written statement that she and all staff will review Title 22 Regulations and view the Departments website
(https://ccld.childcarevideos.org) limitations on capacity.
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After viewing and reviewing the information Director agrees to provide a second written statement on how she all staff will ensure that limitations on capacity will be met. The initial written statement shall be submitted by 10/3//2024. A sign-in sheet of staff reviewing information shall also be submitted.
Type A
10/03/2024
Section Cited
CCR101216.3(a)

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Teacher-Child Ratio: There shall be a ratio of one teacher visually observing and supervising no more than 12 children in attendance. Based on LPA's observation, the licensee did not comply with the section cited above. LPA observed one staff alone caring for 25 children.
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The Director agrees to provide a written statement that she and all staff will review Title 22 Regulations and view the Departments website
(https://ccld.childcarevideos.org) regarding Teacher-Child Ratios.
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After viewing and reviewing the information Director agrees to provide a second written statement on how she all staff will ensure that Teacher-Child ratios will be met. The initial written statement shall be submitted by 10/3//2024. A sign-in sheet of staff reviewing information shall also be submitted.
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:Megan Aviles
LICENSING EVALUATOR NAME:Laura Chavez
LICENSING EVALUATOR SIGNATURE:
DATE: 10/02/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/02/2024


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 10/02/2024 03:53 PM - It Cannot Be Edited


Created By: Laura Chavez On 10/02/2024 at 02:54 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
, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME: WORLD CHANGERS ACADEMY (PS)
FACILITY NUMBER: 483008079

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/02/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/03/2024
Section Cited
CCR
101216.4(a)(2)

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Preschool Program with Toddler Component:
The toddler program shall be conducted in areas physically separate from those used by older or younger children.

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The Director agrees to provide a written statement on how she will ensure that children enrolled in the toddler option will not be co-mingled with preschool age children.
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Based on LPA's observation, the licensee did not comply with the section cited above. LPA observed 3 toddlers enrolled in the toddler program co-mingling with preschool age children.
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The plan of correction shall be submitted to CCLD on or before 10/3/2024.

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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:Megan Aviles
LICENSING EVALUATOR NAME:Laura Chavez
LICENSING EVALUATOR SIGNATURE:
DATE: 10/02/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/02/2024


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, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME: WORLD CHANGERS ACADEMY (PS)
FACILITY NUMBER: 483008079
VISIT DATE: 10/02/2024
NARRATIVE
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LPA Laura Chavez informed the Director to provide a copy of this licensing report dated 10/2/2024 that documents any Type A citation(s) 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 Director Erica Mejia. Appeal Rights were provided.

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

An exit interview was conducted, and report was reviewed with Director Erica Mejia.
SUPERVISORS NAME: Megan Aviles
LICENSING EVALUATOR NAME: Laura Chavez
LICENSING EVALUATOR SIGNATURE:

DATE: 10/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/02/2024
LIC809 (FAS) - (06/04)
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