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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 340317944
Report Date: 09/03/2024
Date Signed: 09/03/2024 01:41:44 PM


Document Has Been Signed on 09/03/2024 01:41 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:EDWARD KEMBLE PRESCHOOLFACILITY NUMBER:
340317944
ADMINISTRATOR:VINCENT, ROSELINEFACILITY TYPE:
850
ADDRESS:7495 29TH STREET, ROOM 25TELEPHONE:
(916) 399-5028
CITY:SACRAMENTOSTATE: CAZIP CODE:
95822
CAPACITY:48CENSUS: 19DATE:
09/03/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Chao XiongTIME COMPLETED:
02:00 PM
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Licensing Program Analyst (LPA) Christopher Bello arrived at the facility at approximately 12:00pm and conducted an unannounced random annual inspection today. LPA met with Site Supervisor, Chao Xiong. The facility is located in room P2 on the Edward Krembel Elementary school. A tour of the facility was conducted inside and outside. The following areas comply during the inspection. There are no bodies of water. Firearms and ammunition are not on the premises. Storage for poisons are locked. Disinfectants, hazardous items and medications are inaccessible to children. Furniture and equipment are enough, age appropriate and in good repair. Fire drills are conducted and documented. Carbon Monoxide detectors were present. The playground equipment and outdoor activity space is maintained and in good condition. Wood chips are being used as cushioning around the climbing equipment and level is enough to absorb a fall. Children's toilets, hand washing facilities are sanitary. Floors are clean and free of debris. Food is prepared and provided by the Elementary school cafeteria. Drinking water is available both indoors and outside. Menus are posted. The facility follows conditions and limitations specified on the license. Sign in/sign out sheets are maintained. No excluded individuals are present. Staff subject to a criminal record clearance or exemption are associated to the facility. First Aid/CPR reviewed and in compliance. Emergency information reviewed for some children. Some staff records were reviewed.

Licensee [or facility representative] 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 provided the Community Care Licensing’s website www.ccld.ca.gov, so the licensee can obtain updated licensing information, new regulations and access forms. LPA advised licensee of their responsibility to stay current in regards to new regulations.
REPORT CONTINUES ON NEXT PAGE.
SUPERVISOR'S NAME: Amanda BlesiTELEPHONE: (916) 208-3427
LICENSING EVALUATOR NAME: Christopher BelloTELEPHONE: (916) 862-0844
LICENSING EVALUATOR SIGNATURE:
DATE: 09/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/03/2024
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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: EDWARD KEMBLE PRESCHOOL
FACILITY NUMBER: 340317944
VISIT DATE: 09/03/2024
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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 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-carecenters/.

LPA advised licensee to sign up for the quarterly updates provided by the Childcare Advocates Program. LPA provided the link https://www.cdss.ca.gov/inforesources/Community-Care-Licensing/subscribe for the licensee to sign up for the updates.

Licensee [or facility representative] 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.

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.

No Title 22 Deficiencies observed in the areas that were evaluated. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with Site Supervisor [or facility representative] Chao Xiong.
SUPERVISOR'S NAME: Amanda BlesiTELEPHONE: (916) 208-3427
LICENSING EVALUATOR NAME: Christopher BelloTELEPHONE: (916) 862-0844
LICENSING EVALUATOR SIGNATURE:

DATE: 09/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2024
LIC809 (FAS) - (06/04)
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