340317948-5-1-2023-03-CC-TWAN-CRETR9-20230501145711

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 340317948
Report Date: 05/01/2023
Date Signed: 05/01/2023 04:37:17 PM

Document Has Been Signed on 05/01/2023 04:37 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
RIVER CITY (SACTO)CC, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME:	ETHEL PHILLIPS PRESCHOOL		FACILITY NUMBER:	340317948
ADMINISTRATOR:	PALMER/POWELL		FACILITY TYPE:	850
ADDRESS:	2930 21ST AVENUE		TELEPHONE:	(916) 277-6252
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95820
CAPACITY:	50	CENSUS: 32	DATE:	05/01/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Loretta Mcclendon		TIME COMPLETED:	03:20 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On Monday, May 1, 2023, Licensing Program Analysts (LPAs) Tanya Washington and Eduardo Barragan met with the Facility Representative, Loretta McClendon for an unannounced one year annual inspection. Upon arrival, LPAs observed care and supervision of 19 children with three staff in classroom #D8, LPAs also observed 13 children with two staff in classroom #D7. Facility is operating within the capacity and in compliance with staff child ratio on this day. Classroom #D8 is open Monday- Thursday from 8:30 AM to 3 PM, on Friday's from 8:30 AM to 12:15 PM. Classroom #D7 is open Monday- Thursday from 11:30 AM to 2:30 PM. Licensing staff toured both classrooms and checked the facility for safety hazards. LPAs observed the facility has a functioning smoke detector, carbon monoxide detector, first aid supplies and a working telephone. There is fully charged fire extinguisher. All of the cleaning solutions, poisons and other chemicals that are dangerous to children are stored out of children's reach. Facility has age appropriate furniture. Furniture is steady and in good repair. Facility has sufficient amount of sleeping cots and each cot was covered with a clean sheet. All toilets, hand washing facilities are in working condition with proper sanitation in place. All storage containers for solid waste are in good repair and have proper tight - fitted lids. Facility has drinking water available for children inside. Facility Representative stated they allow children inside to drink water if they become thirsty while outside. All food is protected from contamination, breakfast, snacks and lunch is delivered to the classroom daily. Parents receive the menu through an app called Learning Genie. LPAs reviewed milk and snacks served for expiration dates, all items today were fresh and no expired items were observed. LPAs observed storage and expiration dates of medication for children, medicine observed was properly stored and not expired. LPAs toured the playground and did not observe and loose or sharp parts. The play structure is age appropriate. Licensing staff observed turf material under the play structure which is sufficient to prevent a fall injury. LPAs reviewed the facility records. LPAs observed a daily sign in and out log. Facility has well maintained roster available on site. LPAs observed the facility has license and all of the other required documents posted at the entrance of the classroom visible for the public. Continued on LIC809C

SUPERVISOR'S NAME: Amanda Blesi	TELEPHONE: (916) 208-3427
LICENSING EVALUATOR NAME: Tanya Washington	TELEPHONE: 916-879-1209
LICENSING EVALUATOR SIGNATURE:	DATE: 05/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2023

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: ETHEL PHILLIPS PRESCHOOL	FACILITY NUMBER: 340317948
	VISIT DATE: 05/01/2023

NARRATIVE

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LPAs reviewed five random children's and four staff files. LPAs observed facility has record of names, addresses and telephone numbers of each child's authorized representative. All staff present today have criminal record clearances through SCUSD school district. Facility Representative McCLendon has a current CPR and First Aid certification which is valid until 02/25/25. LPAs observed that staff present are fully qualified and have the required ECE courses. LPA observed a current fire drill log. Facility has an updated children roster on file. Facility is aware that all staff is required to complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com. LPA observed required certification in each staff file.

All Child Care Centers (CCCs) that are located in buildings constructed before January 1, 2010 must have their drinking water tested for lead and post the results by January 1, 2023 and every 5 years after the date of the initial test. For a license issued on or after July 1, 2022, the CCC must have its water tested and post the results within 180 days of licensure. This facility has the water tested and submitted the result report to the department.

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 encouraged facility representative to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates. Facility Representative can also email at childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list for quarterly updates.

The copy of this report is reviewed and provided to facility representative Loretta McClendon . Notice of site visit is posted and shall remain posted for next 30 days.

See LIC809D for the citations that were noted during today's inspection. Appeal rights provided and explained.

SUPERVISOR'S NAME: Amanda Blesi	TELEPHONE: (916) 208-3427
LICENSING EVALUATOR NAME: Tanya Washington	TELEPHONE: 916-879-1209
LICENSING EVALUATOR SIGNATURE:	DATE: 05/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 05/01/2023 04:37 PM - 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: ETHEL PHILLIPS PRESCHOOL	FACILITY NUMBER: 340317948
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/01/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101239.2(a)

Drinking Water

(a) Drinking water from a noncontaminating fixture or container shall be readily available both indoors and in the outdoor activity area. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	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 if the children become thirsty while outside they are escorted by staff inside for a drink of water.
	POC Due Date: 05/15/2023
	Plan of Correction
1 2 3 4	Facility Representative will come up with a plan to have drinking water readily available for children while outdoors. Facility Representative will notify LPA in writing of the plan by POC date of 05/15/23.

Type B

Section Cited

CCR

101216(g)(2)

Personnel Requirements

(2) Each person specified in (g) above shall have a health-screening report signed by the person performing the screening. This report shall indicate the following: This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above which poses a potential health, safety or personal rights risk to persons in care. Three out of four staff files reviewed did not have verification of health-screening.
	POC Due Date: 06/01/2023
	Plan of Correction
1 2 3 4	Facility Representative will ensure that all staff present have a required health screening report.

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 Blesi	TELEPHONE: (916) 208-3427
LICENSING EVALUATOR NAME: Tanya Washington	TELEPHONE: 916-879-1209
LICENSING EVALUATOR SIGNATURE:	DATE: 05/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 05/01/2023 04:37 PM - 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: ETHEL PHILLIPS PRESCHOOL	FACILITY NUMBER: 340317948
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/01/2023

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
1 2 3 4	Based on interview with facility representative, the licensee did not comply with the section cited above which poses a potential health, safety or personal rights risk to persons in care. Licensing staff learned that Loretta McClendon became a site supervisor for this facility in the beginning of the year.
	POC Due Date: 06/01/2023
	Plan of Correction
1 2 3 4	LPA provided Facility Representative with a list of required items that must be submitted to make an official change.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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 Blesi	TELEPHONE: (916) 208-3427
LICENSING EVALUATOR NAME: Tanya Washington	TELEPHONE: 916-879-1209
LICENSING EVALUATOR SIGNATURE:	DATE: 05/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2023

LIC809 (FAS) - (06/04)

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