CANYON VISTA ELEMENTRY SCHOOL

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25On 07/17/2025 at 1:30pm, Licensing Program Analyst (LPA) Sarah Garcia and Licensing Program Manager (LPM) Nguyen Tran conducted a case management- incident visit in response to a self-reported unusual incident report (LIC 624) received on 06/12/25 regarding children’s personal rights being violated. This is a continuation of the investigation initiated on 6/24/25. LPA met with assistant director, Irem Sepici and director, Lori Silva. A walk through of the facility was conducted, and census was taken. Total census was 52 school age children and 4 staff. A review of staff criminal clearance records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. On 06/12/2025, a self-reported Unusual Incident Report (UIR) was filed with the Licensing Office. The facility reported that on 06/10/25, Staff 3 (S3) is no longer working at the facility due to Child 1 (C1) alleging that S3 slapped them. The facility Human Resources (HR) department conducted an internal investigation and S3 admitted to tapping the child on the shoulder as a result of asking C1 multiple times to refrain from using profanity and making inappropriate comments. Facility HR spoke with authorized representatives of C1 on 6/16/2025 and 6/17/2025. During the course of the investigation, LPA Garcia interviewed 3 staff, authorized representative/parent and Child 1 (C1). LPA obtained C1's LIC 700, S3's personnel record (LIC 501), LIC 624, facility plan of correction, facility discipline guide, training agenda, and staff sign in sheet from training conducted on 6/18/2025. Continued on Page 2 NAME OF LICENSING PROGRAM MANAGER: Martha Malane NAME OF LICENSING PROGRAM ANALYST: Sarah Garcia LICENSING PROGRAM ANALYST SIGNATURE: DATE: 07/17/2025 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/17/2025 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 4 FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form. DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies: Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care. Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care. PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency. CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the d

Type A citation - immediate risk to health, safety, or personal rights

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25On 07/17/2025 at 1:30pm, Licensing Program Analyst (LPA) Sarah Garcia and Licensing Program Manager (LPM) Nguyen Tran conducted a case management- incident visit in response to a self-reported unusual incident report (LIC 624) received on 06/12/25 regarding children’s personal rights being violated. This is a continuation of the investigation initiated on 6/24/25. LPA met with assistant director, Irem Sepici and director, Lori Silva. A walk through of the facility was conducted, and census was taken. Total census was 52 school age children and 4 staff. A review of staff criminal clearance records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. On 06/12/2025, a self-reported Unusual Incident Report (UIR) was filed with the Licensing Office. The facility reported that on 06/10/25, Staff 3 (S3) is no longer working at the facility due to Child 1 (C1) alleging that S3 slapped them. The facility Human Resources (HR) department conducted an internal investigation and S3 admitted to tapping the child on the shoulder as a result of asking C1 multiple times to refrain from using profanity and making inappropriate comments. Facility HR spoke with authorized representatives of C1 on 6/16/2025 and 6/17/2025. During the course of the investigation, LPA Garcia interviewed 3 staff, authorized representative/parent and Child 1 (C1). LPA obtained C1's LIC 700, S3's personnel record (LIC 501), LIC 624, facility plan of correction, facility discipline guide, training agenda, and staff sign in sheet from training conducted on 6/18/2025. Continued on Page 2 NAME OF LICENSING PROGRAM MANAGER: Martha Malane NAME OF LICENSING PROGRAM ANALYST: Sarah Garcia LICENSING PROGRAM ANALYST SIGNATURE: DATE: 07/17/2025 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/17/2025 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 4 FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form. DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies: Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care. Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care. PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency. CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the d