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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 340317946
Report Date: 05/09/2023
Date Signed: 05/10/2023 08:12:42 AM


Document Has Been Signed on 05/10/2023 08:12 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
RIVER CITY (SACTO)CC, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833



FACILITY NAME:EARL WARREN PRESCHOOLFACILITY NUMBER:
340317946
ADMINISTRATOR:HO, CHELSEAFACILITY TYPE:
850
ADDRESS:5420 LOWELL STREETTELEPHONE:
(916) 382-5934
CITY:SACRAMENTOSTATE: CAZIP CODE:
95820
CAPACITY:48CENSUS: 0DATE:
05/09/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Suzie SarabaTIME COMPLETED:
02:50 PM
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On May 9th, 2023, at 1:00 PM, Licensing Program Analyst (LPA) Tanya Washington, met with Facility Representative, Suzie Saraba for an unannounced required annual inspection. Facility Representative informed LPA that this week children get out at 11:45 AM due to parent- teacher conferences. All individuals subject to criminal record background check have obtained a fingerprint clearance through Sacramento City Unified School District. Facility hours of operation are Monday through Thursday from 8 AM to 2:30 PM and on Friday's from 8 AM to 11:45 AM. Facility Representative Saraba informed LPA that classroom P2 is used by the Earl Warren Elementary Transitional Kindergarten students and is not used by preschool children at all this year. Classroom P2 was not inspected during the inspection.

LPA inspected all activity and classroom spaces, restrooms, and outdoor play areas. Hazardous items are inaccessible to children. The floors appeared clean throughout the facility. Furniture and equipment are in safe, operable condition. LPA observed a variety of age-appropriate toys available to children within the facility. The outdoor play area is shared with the elementary school transitional kindergartners, there is a schedule in place for outdoor play. Playground equipment is in good repair and free of loose or sharp parts. LPA observed adequate cushioning in areas underneath climbing equipment and adequate shade provided. Toileting facilities are in safe, sanitary, and operating condition. Uncontaminated drinking water is readily available to children both indoors and outdoors. Storage containers with solid waste have tight-fitting covers in the classroom. Medications are stored in a central location, LPA checked the medication for expiration dates and proper storage. LPA observed a functional carbon monoxide detector within the facility. This facility uses electronic sign in and out system called Child Plus. LPA observed required postings, a children’s roster, and a fire/disaster drill log in which the last drill was conducted on 04/20/2023. Facility provides breakfast, snack and lunch which is prepared at the elementary school cafeteria and brought over to the classroom. Facility uses Fluff and Fold Laundry Services for sheet cleaning, the sheets are cleaned weekly.

LPA reviewed records for three staff. At least one staff member present today has current Pediatric CPR and First Aid certification, expiring 05/03/2025. All staff currently employed with the facility have a health screening report, current Mandated Reporter training, immunizations and documentation of their educational background, training, and/or experience. A sample of children records were reviewed, LPA observed that each child's file contained the required documents.

Continued on LIC809-C

SUPERVISOR'S NAME: Amanda BlesiTELEPHONE: (916) 208-3427
LICENSING EVALUATOR NAME: Tanya WashingtonTELEPHONE: 916-879-1209
LICENSING EVALUATOR SIGNATURE:
DATE: 05/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/09/2023
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
RIVER CITY (SACTO)CC, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME: EARL WARREN PRESCHOOL
FACILITY NUMBER: 340317946
VISIT DATE: 05/09/2023
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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.

LPA discussed with facility representative any changes that may occur regarding the director or an employee acting in the director's absence must be reported to department within ten working days.

LPA encouraged the Facility Representative to the visit the Department's website at WWW.CDSS.CA.GOV for information regarding childcare updates, forms, regulations and legislation pertaining childcare centers. LPA also encouraged the Facility Representative to sign up for the Child Care Advocates quarterly newsletter.

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.

One Type B deficiency is cited on the following LIC809D. Appeal Rights are provided.

This report was reviewed with Facility Representative and an exit interview was conducted. A Notice of Site Visit was provided and must remain posted for 30 days.

SUPERVISOR'S NAME: Amanda BlesiTELEPHONE: (916) 208-3427
LICENSING EVALUATOR NAME: Tanya WashingtonTELEPHONE: 916-879-1209
LICENSING EVALUATOR SIGNATURE:

DATE: 05/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2023
LIC809 (FAS) - (06/04)
Page: 2 of 3
Document Has Been Signed on 05/10/2023 08:12 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVER CITY (SACTO)CC, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833


FACILITY NAME: EARL WARREN PRESCHOOL
FACILITY NUMBER: 340317946

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/09/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101212(b)
Reporting Requirements
(b) The name of the child care center director, and any fully qualified teacher(s) designated to act in the child care center director's absence, shall be reported to the Department within 10 days of a change of child care center director or designee(s).

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview, the licensee did not comply with the section cited above which poses a potential health, safety or personal rights risk to persons in care. Facility Representative stated she has been a Site Supervisor of classroom in Classroom P1 for the last three years.
POC Due Date: 06/09/2023
Plan of Correction
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LPA provided a list of required information for a Site Supervisor. Facility Representative stated she will work on it and submit everything by 6/9/23.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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: Amanda BlesiTELEPHONE: (916) 208-3427
LICENSING EVALUATOR NAME: Tanya WashingtonTELEPHONE: 916-879-1209
LICENSING EVALUATOR SIGNATURE:
DATE: 05/09/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/09/2023
LIC809 (FAS) - (06/04)
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