340318286-3-22-2023-03-CC-KGUA-CQ6T5L-20230322142543

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 340318286
Report Date: 03/22/2023
Date Signed: 03/22/2023 02:25:53 PM

Document Has Been Signed on 03/22/2023 02:25 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
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	TOTAL ENROLLED CHILDREN: 48	CENSUS: 25	DATE:	03/22/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:00 PM
MET WITH:	Karen Gifford		TIME COMPLETED:	02:40 PM

NARRATIVE

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At 12:00 p.m. on Wednesday, March 22nd, 2023, Licensing Program Analyst (LPA) Karyn Guerra met with Director, Karen Gifford, for the purpose of an unannounced, required - 1 year inspection. Upon arrival, LPA observed a census of 25 napping children supervised by 4 staff. Hours of operation are from 7:00 a.m. - 5:30 p.m., Monday thru Friday.

All individuals subject to criminal background review have obtained criminal record clearance. Director was reminded that all adults 18 and over, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

A health and safety inspection was conducted in the classrooms, restrooms, food service areas, and outdoor play areas. LPA observed the following documents are posted: License, Emergency Disaster Plan, Personal Rights, Parents' Rights Poster, menus, and daily schedule. Cleaning disinfectants and hazardous items are appropriately stored and inaccessible to children. Director stated there are no poisons on the premises. Furniture and equipment are in good condition, and toileting facilities are in safe, sanitary, and operating condition. Bins for solid waste in the have tight fitting lids. The floors appeared clean throughout the facility. The facility provides breakfast, lunch, and afternoon snack. The food preparation space is free of litter and all food was protected against contamination. Drinking water was readily available to children both indoors and outdoors via drinking fountains. Facility uses an online application for sign in and sign out. LPA observed signatures of authorized representatives. There are no firearms nor bodies of water on the premises. LPA observed a functional carbon monoxide detector. Disaster drills have been conducted and documented. Playground equipment and surfaces are free of loose or sharp parts. There is turf and cushioning

Report continues on 809-C.

SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Karyn Guerra
LICENSING EVALUATOR SIGNATURE:	DATE: 03/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2023

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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Document Has Been Signed on 03/22/2023 02:25 PM - It Cannot Be Edited

Created By: Karyn Guerra On 03/22/2023 at 01:53 PM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: GOOD NEIGHBORS	FACILITY NUMBER: 340318286
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/22/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.7995(a)(1)

General Provisions and Definitions

(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review and interview, the licensee did not comply with the section cited above in 5 out of 6 staff files reviewed as a proof of immunization or immunity for measles was missing, which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 04/24/2023
	Plan of Correction
1 2 3 4	Director will provide documentation of measles immunization for all staff by POC due date.

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:

Seychelle De Luca

LICENSING EVALUATOR NAME:

Karyn Guerra

LICENSING EVALUATOR SIGNATURE:

DATE: 03/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2023

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: 03/22/2023

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beneath the play structure and foam cushioning beneath the swings. Outdoor shade is provided by trees and a permanent canopy structure.

Staff files were reviewed. At least one staff member present today has current Pediatric CPR and First Aid certification. LPA observed immunization records and documentation of the educational background, training, and/or experience and AB 1207 Mandated Reporter training certificates. 5 out of 6 staff files were missing proof of immunization or immunity for Measles. This poses a potential risk to the health and safety of children in care.

Children's records were reviewed. Each child's file contained an emergency card, consent for emergency medical treatment and notifications of children’s and parent’s rights, health history, physician's report and immunization records. LIC9224 was addressed in admission agreements.

No children in care require medications. This facility is not currently providing Incidental Medical Services – IMS. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.

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.

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.

Title 22 deficiencies are cited on the subsequent pages of this report. Appeal rights were provided. Director's signature on this report acknowledges receipt of these rights. An exit interview conducted and report was reviewed with Director, Karen Gifford. A notice of site visit was given and must remain posted for 30 days.

SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Karyn Guerra
LICENSING EVALUATOR SIGNATURE:	DATE: 03/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2023

LIC809 (FAS) - (06/04)

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