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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566215667
Report Date: 05/16/2023
Date Signed: 05/16/2023 12:43:14 PM

Document Has Been Signed on 05/16/2023 12:43 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, THEFACILITY NUMBER:
566215667
ADMINISTRATOR:DULCE CONTRERASFACILITY TYPE:
850
ADDRESS:2003 YOSEMITE AVENUETELEPHONE:
(805) 520-5913
CITY:SIMI VALLEYSTATE: CAZIP CODE:
93063
CAPACITY: 106TOTAL ENROLLED CHILDREN: 106CENSUS: 89DATE:
05/16/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:24 AM
MET WITH:Samantha CroceTIME COMPLETED:
01:00 PM
NARRATIVE
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On May 16, 2023 Licensing Program Analysts (LPA's) Susana Martinez and Daniel Venegas conducted an unannounced case management- other inspection. LPA's met with director Samantha Croce. Together with the director, LPA's toured the facility inside and outside. At the time of inspection there were 89 children along with 8 staff members.

While conducting a tour of the outside play yard LPA's observed one teacher (S1) alone to 17 children. Children in that class are from PS1. At 10:23 AM, LPA's heard center Director Samantha Croce ask S1 where the other teacher (S2) was. S1 stated she took some children to the restroom. At 10:28 AM LPA's observed children in PS1 classroom transition back into the indoor classroom. LPA's observed S1 leading the children indoors. Director stepped in to assist S1. Some children followed S1 into the building while others were still outside. S2 was not observed to be near the children.

During the tour, LPA's observed 4 staff members not associated to the facility personnel roster. LPA asked director why these staff members were not associated. Director stated she was sure she associated these employees to the facility. While sitting in the office with the director, LPA's observed the 4 employees being associated to the facility. LPA's asked S1 how long she has been working at the center for, S1 stated for about a month. The other 3 staff members were subs which have previously worked at the center prior to today's date.

Two Type A deficiencies are being cited in accordance to Title 22 of the California Code of Regulations and/or Health & Safety codes. Please refer to LIC809D for documentation of deficiencies cited.

A copy of this report must be provided to the authorized representatives of all currently enrolled children and must also be provided to newly enrolled children for the next 12 months. The report shall be provided no later than the next business day or the next day the child is in care.

Continued on 809-C
SUPERVISORS NAME: George Mingle
LICENSING EVALUATOR NAME: Susana Martinez
LICENSING EVALUATOR SIGNATURE: DATE: 05/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/16/2023
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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Document Has Been Signed on 05/16/2023 12:43 PM - It Cannot Be Edited


Created By: Susana Martinez On 05/16/2023 at 11:38 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
, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: LEARNING EXPERIENCE, THE
FACILITY NUMBER: 566215667

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/16/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/30/2023
Section Cited
CCR
101216.3

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101216.3 Teacher-Child Ratio (a) There shall be a ratio of one teacher visually observing and supervising no more than 12 children in attendance, except as specified in (b) and (c) below. (1) The number of children in attendance shall not exceed licensed capacity. This requirement was not met as evidence by:
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A civil penatly for repeat violation has been issued. Director is to submit a written plan of correction to indicate how the center will prevent being out of ratio in the future.
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Based on observations, interviews, and record review, the licensee did not comply with the section cited above as staff admitted to being out of ratio which poses an immediate health, safety or personal rights risk to the children in care.
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Type B
05/30/2023
Section Cited
CCR102370(d)(1)

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102370(d) 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: (1) Obtain a California clearance or a criminal record exemption as required by the Department or

This requirement is not met as evidenced by:
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A civil penalty has been issued. Director is to submit a written plan of correction to indicate how the center plans on ensuring all staff members are associated to the facility. LPA observed director associate the staff members using Guardian.
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Based on observation, interview, and record review, the licensee did not comply with the section cited above. LPA observed staff (S1) present and caring for children in care. S1 is not associated to the facility. S1 stated she has been working at the facility for about a month now which poses an immediate 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:George Mingle
LICENSING EVALUATOR NAME:Susana Martinez
LICENSING EVALUATOR SIGNATURE:
DATE: 05/16/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/16/2023


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: 05/16/2023
NARRATIVE
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The ACKNOWLEDGEMENT OF RECEIPT OF LICENSING REPORTS (LIC 9224) shall be signed and kept in each of the children’s records. Web site address to obtain forms, review quarterly updates, review Title 22 & Health & Safety Codes is: https://www.cdss.ca.gov/inforesources/child-care-licensing

Copies of this report must be posted for 30 days in a visible location for the authorized representatives of children. Notice of Site Visit has been posted (LIC9213). The notice shall be posted for 30 consecutive days. Failure to maintain posting as required will result in a $100.00 civil penalty.

Exit interview conducted with Director Samantha Croce. A copy of the Appeal Rights (LIC 9058 FAS 01/16) were given and explained. Licensee’s signature on this form acknowledges receipt of these rights.
SUPERVISORS NAME: George Mingle
LICENSING EVALUATOR NAME: Susana Martinez
LICENSING EVALUATOR SIGNATURE:

DATE: 05/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/16/2023
LIC809 (FAS) - (06/04)
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