340316212-9-24-2019-03-CC-MBED-BGBPKX-20190924112351

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 340316212
Report Date: 09/24/2019
Date Signed: 09/24/2019 11:23:57 AM

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:	SETA - PARKER AVENUE HEAD START		FACILITY NUMBER:	340316212
ADMINISTRATOR:	WHITEN, NIKKI		FACILITY TYPE:	850
ADDRESS:	4516 PARKER AVENUE		TELEPHONE:	(916) 563-5071
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95820
CAPACITY:	20	CENSUS: 11	DATE:	09/24/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	10:40 AM
MET WITH:	Maria Melgoza		TIME COMPLETED:	11:40 AM

NARRATIVE

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Licensing Program Analysts (LPAs) Tanya Washington and Marea Behvand met with Site Supervisor Maria Melgoza for the purpose of an unannounced annual random inspection. Site Supervisor was reminded never to exceed the conditions, limitations, and capacity specified on the license. Upon arrival LPAs observed 11 preschool children. Facility hours of operation are Monday through Thursday from 8:00 AM to 2:30 PM.

LPAs toured all activity and classroom spaces, restrooms, food service, and outdoor play area. LPAs reviewed storage of medication and Site Supervisor stated that there are currently no children in need of medications. Site Supervisor stated there are no poisons on the premises. 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. Toileting facilities are in safe, sanitary, and operating condition. The floors appeared clean throughout the facility. Site Supervisor stated that all hot meals, including snacks are delivered to the facility by Head Start daily. Storage containers with solid waste have tight-fitting covers. Program provides breakfast, lunch and afternoon snack. Menus were posted and drinking water was readily available to children both indoors and outdoors. Facility utilizes electronic sign-in and out system, in case of power outage or system malfunction, facility utilizes a classroom roster for manual sign in and out.

Report continues on 809-C.

SUPERVISOR'S NAME: Roxana Saravia	TELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Marea Behvand	TELEPHONE: (916) 216-7793
LICENSING EVALUATOR SIGNATURE:	DATE: 09/24/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2019

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: SETA - PARKER AVENUE HEAD START	FACILITY NUMBER: 340316212
	VISIT DATE: 09/24/2019

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A sample of staff and children's records were reviewed. Each child's file contained an emergency card and a consent for medical treatment. At least one staff member present today has current Pediatric CPR and First Aid certification (exp. 09/2021).

All staff currently employed with the facility have criminal record clearances which are associated to the SETA- Natomas Bannon Creek Facility #340313658, health screening report, and documentation of the educational background, training, and/or experience. Program has approval from Sacramento Regional Office to use alternate Mandated Reporter training. LPAs reminded Site Supervisor that 100% supervision is required at all times, including in the bathroom. There are no firearms or bodies of water on the premises. LPAs observed a functional carbon monoxide detector. LPAs reviewed the Department's inspection authority and discussed with Site Supervisor any changes that may occur regarding the director or an employee acting in the Site Supervisor's absence must be reported to department within ten working days.

The facility's Plan of Operation is located in the Administrative file. 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.

This facility evaluation report was reviewed and discussed with Site Supervisor. A Notice of Site Visit was provided and should remain posted for a period of 30 days for parental review. Site Supervisor was encouraged to the visit the Department's website at WWW.CCLD.CA.GOV for information regarding child care updates, forms, regulations and legislation pertaining child care centers. An exit interview was conducted and in the areas that were evaluated, no deficiencies were observed at the time of the inspection.

SUPERVISOR'S NAME: Roxana Saravia	TELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Marea Behvand	TELEPHONE: (916) 216-7793
LICENSING EVALUATOR SIGNATURE:	DATE: 09/24/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2019

LIC809 (FAS) - (06/04)

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