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Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
566214036
Report Date:
07/01/2022
Date Signed:
07/01/2022 03:16:24 PM
Document Has Been Signed on
07/01/2022 03:16 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
,
6500 HOLLISTER AVE., SUITE 200
GOLETA
,
CA
93117
FACILITY NAME:
SHINING STARS PRESCHOOL & INFANT CENTER
FACILITY NUMBER:
566214036
ADMINISTRATOR:
MICHELLE C. WILCOX
FACILITY TYPE:
830
ADDRESS:
2480C E. LAS POSAS RD.
TELEPHONE:
(805) 987-2132
CITY:
CAMARILLO
STATE:
CA
ZIP CODE:
93010
CAPACITY:
35
TOTAL ENROLLED CHILDREN:
35
CENSUS:
15
DATE:
07/01/2022
TYPE OF VISIT:
Required - 1 Year
UNANNOUNCED
TIME BEGAN:
12:30 PM
MET WITH:
Armida Luevano
TIME COMPLETED:
03:30 PM
NARRATIVE
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On July 1, 2022 12:30 PM, Licensing Program Analyst (LPA), Laura Villanueva conducted an unannounced Required-1 year inspection. LPA met with facility Director, Armida Luevano and informed her the purpose of the inspection. Prior to conducting the inspection, LPA conducted Covid-19 pre screening questions. Director provided LPA a tour of the facility inside and out. There were 15 children in care and 4 staff at the time of the inspection.
LPA observed all required documents posted on the wall at the entrance of the facility. There is an infant classroom adjacent to the toddler classroom. The center provides breakfast, lunch and snacks for the children. The infant's formula, diapers, and wipes are brought from home. The center uses an outdoor concrete and artificial grass area for children to play. LPA observed a canopy and a tree available for shade. The center provides water to children inside and out with containers the children bring from home.
Facility uses an electronic fingerprint for sign-in/sign-out system. LPA reviewed a sampling of children and staff files. There were documents missing. Details on LIC809D.
Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at:
http://www.ada.gov/childqanda.htm
Continued on LIC809C
SUPERVISORS NAME
:
George Mingle
LICENSING EVALUATOR NAME
:
Laura Villanueva
LICENSING EVALUATOR SIGNATURE
:
DATE:
07/01/2022
I acknowledge receipt of this form and understand my
licensing
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
07/01/2022
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
5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY
FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office
,
6500 HOLLISTER AVE., SUITE 200
GOLETA
,
CA
93117
FACILITY NAME:
SHINING STARS PRESCHOOL & INFANT CENTER
FACILITY NUMBER:
566214036
VISIT DATE:
07/01/2022
NARRATIVE
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To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to
inspectionprocess@dss.ca.gov
. For additional information regarding the inspection and its tools and methods, please visit the
Program website
at
www.cdss.ca.gov/inforesources/community-care-licensing/process
.
Director was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.
Citations are listed on LIC809. Safe sleep regulations were provided with an LIC9227 form.
A notice of site visit was given and must remain posted for 30 days.
Exit interview conducted and report was reviewed with the Directo. A copy of this report was given to Director with LIC9224 for parents to sign.
SUPERVISORS NAME
:
George Mingle
LICENSING EVALUATOR NAME
:
Laura Villanueva
LICENSING EVALUATOR SIGNATURE
:
DATE:
07/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
07/01/2022
LIC809
(FAS) - (06/04)
Page:
2
of
5
Document Has Been Signed on
07/01/2022 03:16 PM
- It Cannot Be Edited
Created By:
Laura Villanueva
On
07/01/2022
at
02:38 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
,
6500 HOLLISTER AVE., SUITE 200
GOLETA
,
CA
93117
FACILITY NAME:
SHINING STARS PRESCHOOL & INFANT CENTER
FACILITY NUMBER:
566214036
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE:
07/01/2022
DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
101439(b)
Infant Care Center Fixtures, Furniture, Equipment and Supplies
(b) The infant care center shall be equipped with appropriate furniture and equipment including, but not limited to, cribs, cots or mats; changing tables; and feeding chairs.
This requirement is not met as evidenced by:
Deficient Practice Statement
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3
4
Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above in [count] out of [total count] [(objects) (persons)] [identifiers] which poses an immediate health, safety or personal rights risk to persons in care.
There is an infant high table to hold 5 children. The other infants have to wait. More infant high chairs for eating need to be available.
POC Due Date:
07/08/2022
Plan of Correction
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Provide more inants high chairs for eating. An office meeting will be scheduled with owners and Director.
Section Cited
Deficient Practice Statement
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3
4
POC Due Date:
Plan of Correction
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2
3
4
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:
George Mingle
LICENSING EVALUATOR NAME:
Laura Villanueva
LICENSING EVALUATOR SIGNATURE:
DATE:
07/01/2022
I acknowledge receipt of this form and understand my
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
07/01/2022
LIC809
(FAS) - (06/04)
Page:
3
of
5
Document Has Been Signed on
07/01/2022 03:16 PM
- It Cannot Be Edited
Created By:
Laura Villanueva
On
07/01/2022
at
02:38 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
,
6500 HOLLISTER AVE., SUITE 200
GOLETA
,
CA
93117
FACILITY NAME:
SHINING STARS PRESCHOOL & INFANT CENTER
FACILITY NUMBER:
566214036
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE:
07/01/2022
DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101170(e)(2)
Criminal Record Clearance
(e) 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: (2) Request a transfer of a criminal record clearance as specified in Section 101170(f) or
This requirement is not met as evidenced by:
Deficient Practice Statement
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2
3
4
Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above in [count] out of [total count] [(objects) (persons)] [identifiers] which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date:
07/08/2022
Plan of Correction
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Director needs to be associated to infant license. An office meeting will be scheduled with owners and Director.
Type B
Section Cited
CCR
101215.1(m)
Child Care Center Director Qualifications and Duties
(m) A child care center director shall complete 16 hours of health and safety training if necessary pursuant to Health and Safety Code Section 1596.866.
This requirement is not met as evidenced by:
Deficient Practice Statement
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4
Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above in [count] out of [total count] [(objects) (persons)] [identifiers] which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date:
07/08/2022
Plan of Correction
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2
3
4
Director needs to complete Health and Safety training. An office meeting will be scheduled with owners and Director
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:
George Mingle
LICENSING EVALUATOR NAME:
Laura Villanueva
LICENSING EVALUATOR SIGNATURE:
DATE:
07/01/2022
I acknowledge receipt of this form and understand my
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
07/01/2022
LIC809
(FAS) - (06/04)
Page:
4
of
5
Document Has Been Signed on
07/01/2022 03:16 PM
- It Cannot Be Edited
Created By:
Laura Villanueva
On
07/01/2022
at
02:38 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
,
6500 HOLLISTER AVE., SUITE 200
GOLETA
,
CA
93117
FACILITY NAME:
SHINING STARS PRESCHOOL & INFANT CENTER
FACILITY NUMBER:
566214036
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE:
07/01/2022
DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101429(a)(2)(C)(3)
Responsibility for Providing Care and Supervision for Infants
(C) Documentation shall be maintained in the infant’s file and be available to the Department for review. Documentation shall include the following: (3) Time of each 15-minute check
This requirement is not met as evidenced by:
Deficient Practice Statement
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2
3
4
Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above in [count] out of [total count] [(objects) (persons)] [identifiers] which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date:
07/01/2022
Plan of Correction
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3
4
15 minute checks are not being completed on a regular basis. An office meeting will be scheduled with owner and Director.
Section Cited
Deficient Practice Statement
1
2
3
4
POC Due Date:
Plan of Correction
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2
3
4
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:
George Mingle
LICENSING EVALUATOR NAME:
Laura Villanueva
LICENSING EVALUATOR SIGNATURE:
DATE:
07/01/2022
I acknowledge receipt of this form and understand my
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
07/01/2022
LIC809
(FAS) - (06/04)
Page:
5
of
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