340314892-4-2-2024-03-CC-MGON-D3XSUH-20240402141109

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 340314892
Report Date: 04/02/2024
Date Signed: 04/02/2024 02:11:18 PM

Document Has Been Signed on 04/02/2024 02:11 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:	GENERAL DAVIE, JR. PRIMARY CENTER		FACILITY NUMBER:	340314892
ADMINISTRATOR:	LEWIS, TIFFANY		FACILITY TYPE:	850
ADDRESS:	1500 DOM WAY		TELEPHONE:	(916) 971-7375
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95864
CAPACITY:	296	CENSUS: 100	DATE:	04/02/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	11:35 AM
MET WITH:	Lisa Teal		TIME COMPLETED:	02:30 PM

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25

On April 2^nd 2024, Licensing Program Analyst (LPA) Mandie Goodwin met with facility administrator Brittney Rand and Licensee representative Lisa Teal for the purpose of an unannounced random inspection. Facility currently operates licensed preschools from ages 2-entry into first grade in rooms 1, 2, 14, 16, and 21. Ages 3-5 are in room 18, and a toddler option is in rooms 4 & 5. Facility hours of operation are 7:00am - 4:30pm. Facility provides breakfast and lunch and a scheduled nap time. LPA toured the facility with administrator, at which time a census of 100 children between the classrooms were observed. Staff criminal record clearances are maintained by the department of education. During visit all ratios were properly adhered to.

A health and safety inspection was conducted in the classrooms, restrooms, food service areas, and outdoor play areas. LPA observed all the required postings. Cleaning disinfectants and hazardous items are appropriately stored and inaccessible to children. LPA reviewed storage of medications in the classrooms. Furniture and equipment are in good condition, and toileting facilities are in sanitary and operating condition. Bins for solid waste have tight fitting lids. The floors appeared clean throughout the facility. LPA observed smoke and carbon monoxide detectors, and fire extinguishers. Nap equipment was stored appropriately with bedding separated. In the toddler room LPA observed that each child under 24 months has a Needs and Services Plan and that 15 minute sleep checks are being conducted. LPA observed a changing table within arms reach of a sink. LPA observed documentation of sign in and sign outs via an online portal, and documentation that facility is conducting emergency disaster drills at least every 6 months.

Children have access to water indoors and outdoors. Playground equipment and surfaces are free of loose or sharp parts. LPA observed sufficient cushioning outdoors. Outdoor shade is provided. There are no firearms or bodies of water on the premises. Administrator stated there are no poisons on the premises.

LPA reviewed present staff files. At least one staff member present today has current Pediatric CPR and First Aid certification. LPA observed immunization records and documentation of the educational background, training, and/or experience. (Report continues 809-C)

SUPERVISOR'S NAME: Seychelle De Luca	TELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Mandie Goodwin	TELEPHONE: (916) 639-2867
LICENSING EVALUATOR SIGNATURE:	DATE: 04/02/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/02/2024

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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: GENERAL DAVIE, JR. PRIMARY CENTER	FACILITY NUMBER: 340314892
	VISIT DATE: 04/02/2024

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Upon review, all staff members had current mandated reporter trainings. LPA advised AB 1207 Mandated Reporter training must be renewed every two years and can be renewed at www.mandatedreporterca.com.

A sample of 8 children's records were reviewed. Each child's file contained an emergency card, consent for emergency medical treatment, health history, a record of immunization’s and notifications of children’s and parent’s rights.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Director was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

LPA referred facility representative to the Department website for lead: Lead Toxicity Prevention and Water Testing Information.

LPA discussed the safe sleep regulations with Director and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed Director of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. Cont. on 809-C

SUPERVISOR'S NAME: Seychelle De Luca	TELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Mandie Goodwin	TELEPHONE: (916) 639-2867
LICENSING EVALUATOR SIGNATURE:	DATE: 04/02/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/02/2024

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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: GENERAL DAVIE, JR. PRIMARY CENTER	FACILITY NUMBER: 340314892
	VISIT DATE: 04/02/2024

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication. Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

Director was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with Lisa Teal and Brittney Rand. Based on the areas evaluated, no title 22 deficiencies were cited today. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISOR'S NAME: Seychelle De Luca	TELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Mandie Goodwin	TELEPHONE: (916) 639-2867
LICENSING EVALUATOR SIGNATURE:	DATE: 04/02/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/02/2024

LIC809 (FAS) - (06/04)

Page: 3 of 3