566215667-4-26-2023-17-CC-SMAZ-CR9R8F-20230426124752

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 566215667
Report Date: 04/26/2023
Date Signed: 04/26/2023 12:48:09 PM

Document Has Been Signed on 04/26/2023 12:48 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:	LEARNING EXPERIENCE, THE		FACILITY NUMBER:	566215667
ADMINISTRATOR:	DULCE CONTRERAS		FACILITY TYPE:	850
ADDRESS:	2003 YOSEMITE AVENUE		TELEPHONE:	(805) 520-5913
CITY:	SIMI VALLEY	STATE: CA	ZIP CODE:	93063
CAPACITY: 106	TOTAL ENROLLED CHILDREN: 106	CENSUS: 0	DATE:	04/26/2023
TYPE OF VISIT:	Office	ANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Kshanika Wijeweera, Cavinda Wijeweera, Karen Kiciich and Samantha Croce		TIME COMPLETED:	12:00 PM

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On April 26, 2023 at 11:00 AM, Regional Manager (RM), Adriana Hernandez, Licensing Program Manager (LPM), Ana Tolentino and Licensing Program Analysts (LPAs), Susana Martinez and Giovani Gonzalez met with Licensee, Kshanika Wijeweera, Cavinda Wijeweera, Karen Kiciich and Director Samantha Croce for a Non-compliance Conference held in person at the Regional Office.

This Non-compliance Conference was called to discuss the following issues or deficiencies:

On 2/28/2023, a complaint was received with the allegations of Staff are not providing adequate care and supervision to prevent injuries and Staff are operating over ratios.

On 4/20/2023, Complaint was substantiated. A type A section CCR 101216(a)(2) was issued for Licensee being out of ratio. Another type A citation was issued section CCR 101229(a)(1) for care and supervision.

Licensee has agreed to the following:
Licensee must ensure to stay in ratio at all times.

Licensee must ensure that at least one (1) fully qualified teacher is visually observing and supervising a maximum of twelve (12) children at all times or; at least one (1) qualified teacher and one (1) aide for every 15 children in attendance; or one (1) fully qualified teacher and one (1) aide with 6 semester units for every eighteen (18) children.

Continued on LIC809C

SUPERVISORS NAME: George Mingle
LICENSING EVALUATOR NAME: Susana Martinez
LICENSING EVALUATOR SIGNATURE:	DATE: 04/26/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/26/2023

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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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: LEARNING EXPERIENCE, THE	FACILITY NUMBER: 566215667
	VISIT DATE: 04/26/2023

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Licensee must operate in compliance Title 22, Division 12 Child Care Regulations at all times.

Licensee must submit a written plan of correction to Community Care Licensing by May 4^th, 2023, indicating how she will comply with the above items.

Facility shall be recommended for the Technical Support Program (TSP).

Licensee is recommended to watch the resources for parents and providers. https://ccld.childcarevideos.org/child-care-center-operators/

Abide by California Code of Regulations, Title 22, Division 12, Chapter 3 which can be found on the licensing website www.ccld.ca.gov.

Licensee was informed that any additional Type A deficiencies may result in an immediate administrative action against the License.

Failure to maintain compliance with this summary and in compliance with regulations, shall result in a more immediate administrative action.

An exit interview was conducted with Licensee, Kshanika Wijeweera Cavinda Wijeweera, and Director Samantha Croce. Licensee and director received a copy of this report for their records

SUPERVISORS NAME: George Mingle
LICENSING EVALUATOR NAME: Susana Martinez
LICENSING EVALUATOR SIGNATURE:	DATE: 04/26/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/26/2023

LIC809 (FAS) - (06/04)

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