340317924-9-19-2019-03-CC-MLOR-BG6RWY-20190919132354

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 340317924
Report Date: 09/19/2019
Date Signed: 09/19/2019 01:24:02 PM

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:	JOHN BIDWELL PRESCHOOL		FACILITY NUMBER:	340317924
ADMINISTRATOR:	XIONG, CHAO		FACILITY TYPE:	850
ADDRESS:	1730 65TH AVENUE		TELEPHONE:	(916) 433-5451
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95822
CAPACITY:	50	CENSUS: 29	DATE:	09/19/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Jean Pierson		TIME COMPLETED:	01:30 PM

NARRATIVE

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Licensing Program Analysts (LPA) Mai Lor and Licensing Program Manager Roxana Saravia met with substitute teacher Jean Pierson for the purpose of an announced annual random inspection. The program operates in Rooms #21 and #22. Upon arrival, LPA and LPM observed 29 children and 6 staff and 3 volunteers on site. LPA and LPM toured the building including all activity and classroom spaces, restrooms, food service and outdoor play areas. Appropriate ratio, care and supervision were observed during the visit. Designee was reminded never to exceed the conditions, limitations and capacity specified on the license. The pre-school provides two separate half-day programs. Room #21 hours are operation are Monday through Friday from 8:00am to 11:30am and from 12:00pm to 3:00pm. Room #22 hours are operation are Monday through Friday from 8:30am to 11:30am and from 12:00pm to 3:30pm. The pre-school operates according to Sacramento City Unified School District (SCUSD) schedule.

LPA and LPM observed that medications, toxic and hazardous items are all stored appropriately and inaccessible to children. Furniture and equipment are in good condition. Playground equipment and surfaces are free of loose or sharp parts. The areas around or under climbing equipment are cushioned with bark to absorb the fall. Toileting facilities are in safe and sanitary condition. The facility provides breakfast, lunch and snacks. Food is provided through the school cafeteria. The food preparation space is free of litter. All food was protected against contamination. Trash cans containing solid waste had lids. Drinking water was readily available to children both indoors and outdoors. Menus were posted and sign in/out sheets consisted of full legal signatures. A random sample of children and staff files were reviewed. Ten children records contained emergency information and consent for emergency medical treatment. At least one staff member present today has current Pediatric CPR and First Aid certification that expires 04/17/2020. Six staff records were reviewed and four of the staff (S1, S2, S3, S4, see LIC 811 dated 9/19/19 for confidential names list) records did not contain the required mandated reporter training.

All staff currently employed with the facility have a criminal record clearance through the SCUSD. There are no firearms or bodies of water on the premises.

SUPERVISOR'S NAME: Roxana Saravia	TELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Mai Lor	TELEPHONE: (916) 491-0182
LICENSING EVALUATOR SIGNATURE:	DATE: 09/19/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2019

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: JOHN BIDWELL PRESCHOOL	FACILITY NUMBER: 340317924
	VISIT DATE: 09/19/2019

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This facility provides Incidental Medical Services- IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing 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.

Substitute teacher was encouraged to the visit the departments website at www.ccld.ca.gov for information regarding child care updates, forms, regulations and legislation pertaining to child care centers.

Lead Exposure Effect brochure was reviewed and provided to the facility. Facility was provided with information on mandated reporter training (AB1207) and alternative mandated reporter training.

Deficiency cited on the subsequent page of this report under the California Code of Regulations, Title 22. Facility was provided a copy of the Appeal Rights (LIC9058). See subsequent LIC 809 page for deficiency cited.

Exit interview conducted and Notice of Site Visit was provided and posted.

SUPERVISOR'S NAME: Roxana Saravia	TELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Mai Lor	TELEPHONE: (916) 491-0182
LICENSING EVALUATOR SIGNATURE:	DATE: 09/19/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2019

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: JOHN BIDWELL PRESCHOOL	FACILITY NUMBER: 340317924
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/19/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 11/04/2019 Section Cited	1 2 3 4 5 6 7	...a licensed child care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training...This requirement is not met as evidenced by:
	8 9 10 11 12 13 14	Based on record review, four staff did not have the required mandated reporter training which poses a potential health and safety to children in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7
	1 2 3 4 5 6 7

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: Roxana Saravia	TELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Mai Lor	TELEPHONE: (916) 491-0182
LICENSING EVALUATOR SIGNATURE:	DATE: 09/19/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2019

LIC809 (FAS) - (06/04)

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