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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 340306386
Report Date: 09/03/2019
Date Signed: 09/03/2019 11:02:46 AM

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:
09/03/2019
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Pamela MorganTIME COMPLETED:
11:15 AM
NARRATIVE
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Licensing Program Analysts (LPAs) Seychelle De Luca and Tanya Washington met Executive Director Pamela Morgan for an unannounced case management inspection. Upon arrival, LPAs observed 16 children and two staff in the classroom. Mrs. Morgan arrived during the inspection. LPAs learned that Pamela Morgan is not the director of this site. LPAs learned that Ms. Morgan is the Executive Director over Oak Park Preschool I and Oak Park Preschool II. LPAs learned Dijanae Williams Howell is the Site Supervisor over this facility. Facility failed to notify LPA De Luca about this change.

A deficiency is cited on the subsequent page of this report under the California Code of Regulations, Title 22. Director was provided a copy of the Appeal Rights (LIC9058) and Director's signature on this form acknowledges receipt of these rights.
SUPERVISOR'S NAME: Roxana SaraviaTELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Seychelle De LucaTELEPHONE: (916) 217-4316
LICENSING EVALUATOR SIGNATURE:

DATE: 09/03/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2019
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 2
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: 09/03/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/01/2019
Section Cited

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Reporting Requirements. The name of the child care center director or fully qualified teacher(s) designated to act in the director’s absence shall be reported to the Department with in 10 days of a change. This requirement is not met as evidenced by LPAs learning that facility staff failed to notify LPA De Luca that
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Dijanae Williams Howell is the Site Supervisor at this site, not Pamela Morgan. This poses a potential health and safety concern to children in care.
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LIC 610, proof of enrollment/completion of EMSA certified CPR/First Aid, and Board Resolution designating Pamela Morgan as Licensee Representative by POC date: 10/1/2019.

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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: 09/03/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/03/2019
LIC809 (FAS) - (06/04)
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