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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 340306413
Report Date: 08/30/2021
Date Signed: 08/30/2021 12:17:19 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:B.J. JORDAN CHILD CARE PROGRAMS - NORTH HIGHLANDSFACILITY NUMBER:
340306413
ADMINISTRATOR:RENDA, GEENAFACILITY TYPE:
850
ADDRESS:3735 STEPHEN DRIVETELEPHONE:
(916) 331-0301
CITY:NORTH HIGHLANDSSTATE: CAZIP CODE:
95660
CAPACITY:54CENSUS: 13DATE:
08/30/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:40 AM
MET WITH:Geena Renda and Karen HammanTIME COMPLETED:
12:30 PM
NARRATIVE
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On August 30th, 2021 at 10:40 AM, Licensing Program Analyst (LPA) Tanya Washington met with Centers' Manager Karen Hamman and Site Supervisor Geena Renda for an unannounced case management inspection.

On August 25th, 2021 facility self-reported an incident which occurred on 08/24/2021. It was reported that on 08/24/2021 at approximately 3:42 PM, Staff #1 and Staff #2 were transitioning a group of children from classroom #3 to the outdoor playground. During the transition Child #1 was left on their cot inside the classroom without adult supervision.

Staff #3 was returning from their break and observed Child #1 alone in the classroom. Staff #3 comforted the child and changed their clothes as the child had a toileting accident.
LPA learned from management that the child's parent was informed of the incident upon pick up.

Based on the interviews there was absence of supervision for approximately 12 minutes.

Since the incident, facility has revised their daily schedule to ensure that all children are awake prior to transitioning outdoors. Facility has also developed an Active Supervision Plan and additional training in active supervision for all staff. Center Manager will also conduct weekly unannounced visits to monitor for safety and supervision.
Site Supervisor stated that they will ensure the children are physically counted prior to entering and exiting the building/ playground. Staff will also utilize walkie- takies for better communication.

Continued on LIC809C
SUPERVISOR'S NAME: Roxana SaraviaTELEPHONE: (916) 263-5744
LICENSING EVALUATOR NAME: Tanya WashingtonTELEPHONE: 916-879-1209
LICENSING EVALUATOR SIGNATURE:

DATE: 08/30/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/30/2021
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 3
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: B.J. JORDAN CHILD CARE PROGRAMS - NORTH HIGHLANDS
FACILITY NUMBER: 340306413
VISIT DATE: 08/30/2021
NARRATIVE
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Upon receipt, facility representative shall post and provide copies of this licensing report to parents/ guardians of children who are currently enrolled as well as parents/ guardians of children newly enrolled at the facility during the next 12 months. Parents/guardians must acknowledge receipt of this report and citation by signing a LIC9224, “ACKNOWLEDGEMENT OF RECEIPT OF LICENSING REPORTS”. A copy of this form should be placed in each child file upon receipt from parent.

LPA discussed this report with facility representative and conducted an exit interview. LPA also provided appeal rights. Notice of site visit posted.


SUPERVISOR'S NAME: Roxana SaraviaTELEPHONE: (916) 263-5744
LICENSING EVALUATOR NAME: Tanya WashingtonTELEPHONE: 916-879-1209
LICENSING EVALUATOR SIGNATURE:

DATE: 08/30/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/30/2021
LIC809 (FAS) - (06/04)
Page: 2 of 3
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: B.J. JORDAN CHILD CARE PROGRAMS - NORTH HIGHLANDS
FACILITY NUMBER: 340306413
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/30/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/30/2021
Section Cited

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No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation.
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This requirement is not met as evidenced: Child #1 was left alone in the classroom when their group transitioned outside. Child #1 was left unattended for approximately 12 minutes. This is an immediate risk to the health and safety of children in care. Civil penalty in the amount of $500.00 is assessed for absence of supervision.
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of correction to licensing by COB 08/31/21.

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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) 263-5744
LICENSING EVALUATOR NAME: Tanya WashingtonTELEPHONE: 916-879-1209
LICENSING EVALUATOR SIGNATURE:
DATE: 08/30/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/30/2021
LIC809 (FAS) - (06/04)
Page: 3 of 3