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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 340306386
Report Date: 05/06/2019
Date Signed: 05/06/2019 02:24:48 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME:OAK PARK PRESCHOOLFACILITY NUMBER:
340306386
ADMINISTRATOR:ARCY, CURRIEFACILITY TYPE:
850
ADDRESS:3500 2ND AVENUETELEPHONE:
(916) 451-9498
CITY:SACRAMENTOSTATE: CAZIP CODE:
95817
CAPACITY:34CENSUS: 16DATE:
05/06/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Pamela MorganTIME COMPLETED:
02:45 PM
NARRATIVE
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Licensing Program Analysts (LPAs) Seychelle De Luca and Tanya Washington met with Director Pamela Morgan for the purpose of an unannounced annual random inspection. Upon arrival LPAs observed 13 preschool children with Director and one teacher in the classroom, and three children with an aide in the office. Facility hours of operation are Monday through Friday 6:30 AM to 5:30 PM.

LPAs toured the classroom, restrooms, food service areas, and outdoor play area. LPAs observed the following documents are posted: License, Emergency Disaster Plan, Personal Rights, Parents' Rights Poster, menus, and daily schedule. Cleaning disinfectants and hazardous items are appropriately stored and inaccessible to children. Medications are appropriately stored and inaccessible to children. Director stated there are no poisons on the premises. Furniture and equipment are in good condition, and toileting facilities are in safe, sanitary, and operating condition. The floors appeared clean throughout the facility. The food preparation space is free of litter, and all food was protected against contamination. Program provides morning snacks, lunch, and afternoon snacks.



There is a water pitcher and cups inside and a cooler and cups outside. LPAs observed full legal signatures while reviewing the sign in and sign out sheet. There is rubber mulch beneath the climbing structure in the outdoor play area. There are shaded areas supplied by canopies. Staff and children's records were reviewed. Each child's file contained an emergency card and a health history.

All staff currently employed with the facility have a criminal record clearance through, health screening report, immunization records, and documentation of the educational background, training, and/or experience.

Report continues on 809-C.
SUPERVISOR'S NAME: Roxana SaraviaTELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Seychelle De LucaTELEPHONE: 916-217-4316
LICENSING EVALUATOR SIGNATURE:

DATE: 05/06/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/06/2019
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
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: OAK PARK PRESCHOOL
FACILITY NUMBER: 340306386
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/06/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/07/2019
Section Cited
CCR
101216.2(e)
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Teacher Aide Qualifications and Duties. An aide shall work only under the direct supervision of a teacher. This requirement is not met as evidenced by LPAs learning S1, an aide with three units, is left alone with children in the office without a fully qualified teacher. This poses an immediate health and safety concern.
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Director will ensure that no aides are left alone to supervise children without a fully qualified teacher in classroom. Director will create a staffing schedule that will ensure a fully qualified teacher, not an aide, is providing supervision. Director will submit schedule to LPA De Luca by 5/7/2019.
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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: Roxana SaraviaTELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Seychelle De LucaTELEPHONE: 916-217-4316
LICENSING EVALUATOR SIGNATURE:

DATE: 05/06/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/06/2019
LIC809 (FAS) - (06/04)
Page: 3 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME: OAK PARK PRESCHOOL
FACILITY NUMBER: 340306386
VISIT DATE: 05/06/2019
NARRATIVE
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There are no firearms or bodies of water on the premises. LPAs observed a functional carbon monoxide detector. LPAs reviewed the Department's inspection authority and discussed with Director any changes that may occur regarding the director or an employee acting in the director's absence must be reported to department within ten working days.

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.

LPAs verified the annual fees are current. LPAs reviewed the following: 100% supervision is required at all times, including in the bathroom and reporting requirements. LPA provided the Child Care Advocates Program email address: childcareadvocatesprogram@dss.ca.gov, so Director can request to be added to the distribution list to receive Quarterly Updates. LPA provided and discussed Effects of Lead Exposure brochure.

Title 22 deficiencies are cited on the subsequent pages of this report.


Licensee acknowledges, that FOR TYPE A DEFICIENCIES ONLY upon receipt, licensee shall post LIC 809D with Type A deficiencies for 30 days and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. LIC 9224 must be signed by parents/guardians and kept with the children's forms as a receipt whenever any Type A documents are provided by the licensee. LIC 9224 and Appeal Rights were provided.
SUPERVISOR'S NAME: Roxana SaraviaTELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Seychelle De LucaTELEPHONE: 916-217-4316
LICENSING EVALUATOR SIGNATURE:

DATE: 05/06/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/06/2019
LIC809 (FAS) - (06/04)
Page: 2 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: OAK PARK PRESCHOOL
FACILITY NUMBER: 340306386
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/06/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/03/2019
Section Cited
CCR
101216(f)
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Personnel Requirements - At least one staff member who is trained in pediatric cardiopulmonary resuscitation and pediatric first aid pursuant to Health and Safety Code Section 1596.866 shall be present when children are at the child care center or offsite for center activities.
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Director will have Lead Teacher and any staff who might be opening or closing the center alone enroll in an EMSA certified CPR/First Aid course. Proof of enrollment will be sent to LPA De Luca by POC date: 6/3/2019.
Type B
06/03/2019
Section Cited
CCR
101217(a)
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Personnel Records. Personnel records shall be maintained on the licensee, administrator, and each employee, and shall contain specified information. This requirement is not met as evidenced by LPAs observing that three out of four staff do not have AB 1207 Mandated Reporter certificates and two out of four are missing full immunization records.
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LPA De Luca will return to check files.

AB 1207 is available at mandatedreporterca.com
Type B
06/03/2019
Section Cited
CCR
101239(n)
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Furniture and equipment shall be maintained in good condition, free of sharp, loose or pointed parts. This requirement is not met as evidenced by LPAs observing unsafe and unclean equipment in the outdoor space. LPAs observed a broken table, broken toys, broken fence, and accessible trash.
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LPA De Luca will return to confirm removal of broken equipment and to ensure the outdoor area is safe and is free of hazards.
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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: Roxana SaraviaTELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Seychelle De LucaTELEPHONE: 916-217-4316
LICENSING EVALUATOR SIGNATURE:

DATE: 05/06/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/06/2019
LIC809 (FAS) - (06/04)
Page: 4 of 4