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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 485407834
Report Date: 12/09/2021
Date Signed: 12/14/2021 07:34:24 AM

Document Has Been Signed on 12/14/2021 07:34 AM - 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:LEARNING EXPERIENCE-INFANT, THEFACILITY NUMBER:
485407834
ADMINISTRATOR:OLDANI, SABRINAFACILITY TYPE:
830
ADDRESS:1959 PEABODY ROADTELEPHONE:
(707) 305-4336
CITY:VACAVILLESTATE: CAZIP CODE:
95688
CAPACITY: 32TOTAL ENROLLED CHILDREN: 32CENSUS: 17DATE:
12/09/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Sabrina OldaniTIME COMPLETED:
10:10 AM
NARRATIVE
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A Case Management visit was conducted to the facility by Licensing Program Analyst, Wisehart who met with Director Sabrina Oldani regarding an incident which occurred on 11/29/21. A child, C1 was found by staff S1 left unattended in the hallway outside of classroom after the children were transitioned from outside play to the classroom by staff S2. The staff interviews indicated the child was unsupervised for approximately 1-2 minutes outside the classroom before being found and brought to the classroom.

The director reported the incident to licensing, on 12/5/21 the director sent out a detailed email to staff about the importance of face to name checks and on 12/8/21 the director provided individual training on face to name checks with staff.

The following violation(s) of the California Code of Regulations, Title 22; Division 12, were observed: see LIC 809D. Appeal Rights were provided.


Notice of Site Visit shall be posted for 30 days from today's visit.
SUPERVISORS NAME: Megan Aviles
LICENSING EVALUATOR NAME: Carrie Wisehart
LICENSING EVALUATOR SIGNATURE: DATE: 12/09/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/09/2021
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 12/09/2021 10:01 AM - It Cannot Be Edited


Created By: Carrie Wisehart On 12/09/2021 at 09:45 AM
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: LEARNING EXPERIENCE-INFANT, THE
FACILITY NUMBER: 485407834

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/09/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/09/2021
Section Cited
CCR
101429(a)(1)

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Responsibility for Providing Care and Supervision for Infants 101429(a)(1)
(a)(1) Each infant shall be constantly supervised and under direct visual observation and supervision by a staff person at all times.
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The director wrote up and terminated S2 for the incident on 12/1/21. The director provided training on the importance of face to name checks between each threshold on 12/8/21. The director also send out a detailed email on 12/5/21. No Further Actions required.
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This requirement was not met as evidenced by: Based on interview C1 was found in the hallway near classroom unsupervised for 1-2 minutes after a transition time and was taken to the classroom.
This poses a potential health, safety or personal rights risk to persons 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:Megan Aviles
LICENSING EVALUATOR NAME:Carrie Wisehart
LICENSING EVALUATOR SIGNATURE:
DATE: 12/09/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/09/2021


LIC809 (FAS) - (06/04)
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