340318286-3-6-2020-03-CC-KGOL-BMFUKH-20200306143911

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 340318286
Report Date: 03/06/2020
Date Signed: 03/06/2020 02:39:19 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:	GOOD NEIGHBORS		FACILITY NUMBER:	340318286
ADMINISTRATOR:	GIFFORD,KAREN		FACILITY TYPE:	850
ADDRESS:	3700 KNIGHTLINGER		TELEPHONE:	(916) 649-6966
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95838
CAPACITY:	48	CENSUS: 24	DATE:	03/06/2020
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:45 PM
MET WITH:	Cynthia Rodrigue		TIME COMPLETED:	02:45 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	Licensing Program Analyst (LPA), Goodell met with staff member Cynthia Rodrigue for an unannounced Annual Inspection. The facility’s hours of operation are Monday-Friday, 7:00am-5:30pm. LPA arrived during naptime and observed 24 children present with 2 staff. All individuals present have obtained fingerprint clearance through Community Care Licensing. LPA observed required postings: Facility License (LIC 203A), Personal Rights (LIC613A), Emergency Disaster Plan (LIC610), Earthquake Preparedness Checklist (LIC9148), and Parent’s Rights Poster (PUB393). LPA toured all activity/classroom areas, children’s furniture, play equipment, napping equipment, food service area, and restrooms. LPA reviewed the electronic sign/in-sign/out sheet. Facility provides breakfast, lunch and snack. LPA observed a current menu and activity posted. LPA observed outdoor area and play equipment. Water is accessible to children both indoor and outdoor. LPA observed fire extinguisher 3A40BC and smoke detector. During inspection staff were unable to locate carbon monoxide detector which poses a potential risk to children in care. Staff acknowledged Every licensed child day care center shall have one or more carbon monoxide detectors in the facility. Staff stated carbon monoxide detector will be installed and proof will be submitted to LPA. LPA observe fire drill log and children roster maintained. LPA reviewed children files. Documents included Identification and Emergency Information (LIC700), Child’s Preadmission Health History (LIC702), Child’s Preadmission Health Evaluation (LIC701), Consent for Medical Treatment (LIC627), Notification of Parent’s Rights (LIC 995), Personal Rights (LIC613A). Report Continues on LIC-809C

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Kristal Goodell	TELEPHONE: (916) 216-7798
LICENSING EVALUATOR SIGNATURE:	DATE: 03/06/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2020

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: GOOD NEIGHBORS	FACILITY NUMBER: 340318286
	VISIT DATE: 03/06/2020

NARRATIVE

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LPA reviewed staff files and educational requirements. Documents included Health Screening Report (LIC503), TB Clearance, Personal Record (LIC501), Criminal Record Statement (LIC508), Notice of Employee Rights, Statement Acknowledging Requirement to Report Suspected Child Abuse (LIC9108) and certificate for Mandated Reporter Training. LPA observed that at least one staff member present during today’s inspection has current Pediatric CPR/First Aid that expires on 1/21/21.

LPA provided a copy of the Effects of Lead Exposure brochure. LPA discussed with the Director Assembly Bill 2370, which will require licensed Child Care Facilities to test their water for excessive amounts of lead. Testing will be required from January 1st, 2020 to January 1st, 2023 and must be conducted every five years from the initial testing.

LPA provided the Community Care Licensing website www.ccld.ca.gov, so the director can obtain updated licensing information, new regulations, self-assessment guides and access forms. LPA advised the director of their responsibility to stay current in regards to new regulations.

Title 22 Deficiency cited on next page (LIC809D). Report reviewed with director. Notice of Site Visit issued and must remain posted for 30 days. Appeal Rights also issued and discussed.

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Kristal Goodell	TELEPHONE: (916) 216-7798
LICENSING EVALUATOR SIGNATURE:	DATE: 03/06/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2020

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: GOOD NEIGHBORS	FACILITY NUMBER: 340318286
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/06/2020

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 03/13/2020 Section Cited	1 2 3 4 5 6 7	Carbon monoxide detectors required; inspection. Every licensed child day care center shall have one or more carbon monoxide detectors in the facility that meet the standards established in Chapter 8 (commencing with Section 13260) of Part 2 of Division 12.
	8 9 10 11 12 13 14	The department shall account for the presence of these detectors during inspections. This requirement is not met due to staff were unable to locate a carbon monoxide detector which poses potenttial risk 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: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Kristal Goodell	TELEPHONE: (916) 216-7798
LICENSING EVALUATOR SIGNATURE:	DATE: 03/06/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2020

LIC809 (FAS) - (06/04)

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