340316146-6-14-2022-03-CC-ASUR-CFDNVK-20220614104804

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 340316146
Report Date: 06/14/2022
Date Signed: 06/14/2022 10:48:12 AM

Document Has Been Signed on 06/14/2022 10:48 AM - 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:	ETHEL I. BAKER PRESCHOOL		FACILITY NUMBER:	340316146
ADMINISTRATOR:	MILLER, MELISSA		FACILITY TYPE:	850
ADDRESS:	5717 LAURINE WAY, ROOM 29		TELEPHONE:	(916) 395-4562
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95824
CAPACITY:	24	CENSUS: 10	DATE:	06/14/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Melissa Miller		TIME COMPLETED:	11:00 AM

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On Tuesday, June 14, 2022 at 9:30 PM, Licensing Program Analysts (LPA) Amanda Sutter and Katrina Owens met with Lead Teacher Melissa Miller for the purpose of an unannounced required annual inspection. Two staff were present upon arrival supervising 10 children at the facility. The facility hours of operation are Monday through Thursday from 8:30 AM to 11:30 AM, and 12:00 PM to 3:00 PM Friday. The facility does not offer transportation services.

LPAs toured classroom space (classroom #29), restroom, and outdoor play area. LPAs observed the following documents are posted: License, Emergency Disaster Plan, Personal Rights, Parents' Rights Poster, menu, fire drill log, seatbelt law, and daily schedule. Cleaning disinfectants, medications and hazardous items are appropriately stored and inaccessible to children. Director stated there are no poisons or firearms on the premises. Furniture and equipment are in good condition, and toileting facilities are in safe, sanitary and operating condition, and the floors appeared to be clean throughout the facility. The program provides breakfast and a snack from the cafeteria.

LPAs observed trash bins with tight fitted lids. Drinking water is readily available to children both indoors and outdoors. Director stated that there is a water pitcher that is used and disposable cups are accessible to children if they request it. LPAs observed the facility’s paper sign in and out system. Facility has record of conducting fire drills at least every six months; last fire drill was conducted in April 19, 2022. Playground equipment and surfaces are free of loose or sharp parts and bark is present under the equipment to provide sufficient cushioning. There are sufficient equipment and toys, and there are shaded areas supplied by a large shade cloth.

Two staff and five children's records were reviewed. Both children and staff files were observed to be complete. There is at least one staff member present with a current CPR certificate. LPA reminded Licensees that 100% supervision is required at all times. LPAs observed a functional carbon monoxide detector, smoke detector and fire extinguisher. PAGE 1. REPORT CONTINUES ON LIC809-C

SUPERVISOR'S NAME: Seychelle De Luca	TELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Amanda Sutter	TELEPHONE: (916) 261-8918
LICENSING EVALUATOR SIGNATURE:	DATE: 06/14/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2022

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: ETHEL I. BAKER PRESCHOOL	FACILITY NUMBER: 340316146
	VISIT DATE: 06/14/2022

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LPAs discussed the safe sleep regulations with licensee 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. LPAS also informed licensee 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.

Incidental Medical Service (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

Director was reminded that all adults 18 and over, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process.

During today’s inspection no deficiencies were observed. A notice of site visit was given and must remain posted for 30 days.

SUPERVISOR'S NAME: Seychelle De Luca	TELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Amanda Sutter	TELEPHONE: (916) 261-8918
LICENSING EVALUATOR SIGNATURE:	DATE: 06/14/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2022

LIC809 (FAS) - (06/04)

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