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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 340309465
Report Date: 08/30/2023
Date Signed: 08/30/2023 02:37:18 PM


Document Has Been Signed on 08/30/2023 02:37 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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827



FACILITY NAME:RAINBOW DAY CAREFACILITY NUMBER:
340309465
ADMINISTRATOR:ANTHONY, MIAFACILITY TYPE:
850
ADDRESS:901 P STREET, SUITE 155BTELEPHONE:
(916) 448-5231
CITY:SACRAMENTOSTATE: CAZIP CODE:
95814
CAPACITY:48CENSUS: 17DATE:
08/30/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Mia AnthonyTIME COMPLETED:
03:45 PM
NARRATIVE
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 On August 30, 2023 at approximately 9:00 AM Licensing Program Analysts Pa Dao Vang and Mandie Goodwin met with Director Mia Anthony for the purpose of an unannounced Case Management investigation. The purpose of this inspection was to follow up on a complaint report submitted to the Licensing program on August 24, 2023. During today's investigation LPAs conducted interviews, made observations, and collected documentation. Based on the interviews, LPAs learned that on 8/30/23 in the morning the preschool and toddler children, who are on a Toddler option program, were combined in the yellow room. There were a total of 13 children together with one staff member for approximately 5 minutes. The investigation result in a deficiency cited LIC809-D.

A copy of this report was reviewed and provided to the Director Mia Anthony. Appeal rights and a notice of site visit were provided.
SUPERVISOR'S NAME: Seychelle De LucaTELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Dao VangTELEPHONE: (916) 216-7798
LICENSING EVALUATOR SIGNATURE:
DATE: 08/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/30/2023
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 08/30/2023 02:37 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827


FACILITY NAME: RAINBOW DAY CARE
FACILITY NUMBER: 340309465

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/30/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/20/2023
Section Cited
CCR
101216.4(a)(2)

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101216.4 (a) (2)
The toddler program shall be conducted in areas physically separate from those used by older or younger children...

This requirement was not met by envidence by
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Director will create a training and have staff sign it. Director will email LPA the training and staff signatures.
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Based on the interviews, LPAs learned the Preschool Program was combined with the Toddler Program for a total of 13 children together with one staff member for approximately 5 minutes. This is considered a potential health, safety, or personal rights risk to children 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: Seychelle De LucaTELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Dao VangTELEPHONE: (916) 216-7798
LICENSING EVALUATOR SIGNATURE:
DATE: 08/30/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/30/2023
LIC809 (FAS) - (06/04)
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