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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 340310907
Report Date: 02/25/2022
Date Signed: 02/25/2022 04:35:28 PM


Document Has Been Signed on 02/25/2022 04:35 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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833



FACILITY NAME:ASSOCIATED STUDENTS CSUS CHILDREN'S CENTERFACILITY NUMBER:
340310907
ADMINISTRATOR:VELTE, SHERRYFACILITY TYPE:
830
ADDRESS:6000 J STREETTELEPHONE:
(916) 278-6216
CITY:SACRAMENTOSTATE: CAZIP CODE:
95819
CAPACITY:57CENSUS: 11DATE:
02/25/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:40 AM
MET WITH:Sherry VelteTIME COMPLETED:
04:45 PM
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Licensing Program Analysts (LPAs) Josiah Gathing and Karyn Guerra met with Director Sherry Velte for the purpose of an unannounced annual random inspection. Director was reminded never to exceed the conditions, limitations, and capacity specified on the license. Upon arrival, LPAs observed 5 infants and 5 staff members in the Bambini 2 room, 6 infants and 3 staff members in the Bambini 3 room. Director reported that Bambini 1 room was not in use since March 2020. Facility hours of operation are Monday through Friday from 7:30 AM to 6:00 PM.

LPAs toured the classroom spaces, restrooms, and outdoor play area. Director stated there are no poisons on the premises. Medications were appropriately stored and inaccessible to children. Toxic and hazardous items are inaccessible to children. Furniture and equipment are in good condition. Playground equipment and surfaces are free of loose or sharp parts. Infant changing tables have a padded surface that is washable and at least one inch thick, and they have raised sides that are at least three inches high. The floors appeared clean throughout the facility. The food preparation space is free of litter and all food was protected against contamination. LPAs observed a bottle which was not labeled with the child's name in the refrigerator of Bambini 2 room. Menus were posted and drinking water was readily available to children both indoors and outdoors. Facility utilizes an electronic sign in and sign out system. LPAs observed full legal signatures of parents or guardians.

Staff and 4 children's records were reviewed. Each child's file contained an emergency card, a medical assessment, and Infant Needs and Services Plan. LPAs observed an individual sleeping plan LIC9227 for infants up to 12 months of age. At least one staff member present today has current Pediatric CPR and First Aid certification (exp. 8/2023). All staff currently employed with the facility have a health screening report, and documentation of educational background, training, and/or experience. LPAs reminded Director that 100% supervision is required at all times. There are no firearms or bodies of water on the premises. Report continues on 809-C.

SUPERVISOR'S NAME: Seychelle De LucaTELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Josiah GathingTELEPHONE: (916) 799-9668
LICENSING EVALUATOR SIGNATURE:
DATE: 02/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/25/2022
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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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: ASSOCIATED STUDENTS CSUS CHILDREN'S CENTER
FACILITY NUMBER: 340310907
VISIT DATE: 02/25/2022
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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 discussed annual fees with Director.

This facility evaluation report was reviewed and discussed with Director. A Notice of Site Visit was provided and should remain posted for a period of 30 days for parental review. Director was encouraged to the visit the Department's website at WWW.CDSS.CA.GOV for information regarding child care updates, forms, regulations and legislation pertaining child care centers. An exit interview was conducted.

No Title 22 Deficiencies cited during inspection. LPA reviewed report with the licensee and provided copies. Notice of Site Visit issued and must remain posted

SUPERVISOR'S NAME: Seychelle De LucaTELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Josiah GathingTELEPHONE: (916) 799-9668
LICENSING EVALUATOR SIGNATURE:

DATE: 02/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/25/2022
LIC809 (FAS) - (06/04)
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