340318380-5-22-2023-03-CC-EPGO-CS3NVG-20230522104756

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 340318380
Report Date: 05/22/2023
Date Signed: 05/22/2023 10:48:01 AM

Document Has Been Signed on 05/22/2023 10:48 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:	PETER J. SHIELDS ELEMENTARY SCHOOL		FACILITY NUMBER:	340318380
ADMINISTRATOR:	MORRIS, VERONICA		FACILITY TYPE:	850
ADDRESS:	10434 GEORGETOWN DRIVE		TELEPHONE:	(916) 635-5416
CITY:	RANCHO CORDOVA	STATE: CA	ZIP CODE:	95670
CAPACITY:	24	CENSUS: 18	DATE:	05/22/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:50 AM
MET WITH:	Keri Meredith		TIME COMPLETED:	11:00 AM

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Licensing Program Analyst Erwina Pascual-Golamco (LPA) met with Facility Representative (FR), Keri Meredith, for an unannounced annual inspection. LPA toured the facility in Preschool Building including all activity and classroom spaces, restrooms, and outdoor play areas. The following areas are in compliance during the visit. Census included 18 preschool children being supervised by 4 classroom staff. FR was reminded never to exceed the conditions, limitations, and capacity specified on the license. Facility hours of operation are Monday through Friday from 8:00am to 11:00am following the Folsom Cordova Unified School District (FCUSD) Calendar. Children do not take naps. All staff present had evidence of current criminal background clearances and/or associations through the FCUSD.

FR 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.

Classrooms are orderly, and free from hazards. Chemicals were kept inaccessible to children. Playground equipment and surfaces were inspected and are in good condition with enough resilient material under climbing structures to cushion fall. Uncontaminated drinking water was readily available to children both indoors and outdoors and children also bring their own water bottles from home. The facility provides Breakfast through the food services provided by FCUSD. LPA observed a posted menu.

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SUPERVISOR'S NAME: Natalie Dunaway	TELEPHONE: (916) 584-3508
LICENSING EVALUATOR NAME: Erwina Pascual-Golamco	TELEPHONE: (916) 206-1524
LICENSING EVALUATOR SIGNATURE:	DATE: 05/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2023

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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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: PETER J. SHIELDS ELEMENTARY SCHOOL	FACILITY NUMBER: 340318380
	VISIT DATE: 05/22/2023

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Bathrooms were observed and all sinks and toilets were sanitary and in operating condition. There are no firearms or bodies of water on the premises and the facility has at least one functioning smoke and carbon monoxide detector. LPA observed all required licensing documentation was posted for parental review. LPA observed that parents are signing their children in and out of the center.

Children’s and staff’s files were reviewed. Children's files had the required licensing documentation. LPA reviewed staff records and observed staff caring for children were qualified. At least one staff had a current Pediatric CPR and First Aid certification. Staff have current Mandated Reporter certificates and proof of immunizations. Technical assistance provided regarding all personnel records shall be maintained at the child care center and shall be available to the licensing agency for review. LPA observed a current children's roster and last fire drill was conducted April 28, 2023 according to Office Personnel. There is First Aid equipment available.

Incidental Medical Services (IMS) were discussed. For additional IMS information, FR was advised to 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.

FR was encouraged to the visit the department's website at WWW.CCLD.CA.GOV for information regarding childcare updates, PINs, forms, regulations and legislation pertaining to childcare centers.

No deficiencies were cited during today's inspection. This report was reviewed with FR, and an exit interview was conducted. A Notice of Site Visit (NOS) was provided to FR, who will post it for a period of 30 days for parental review.

SUPERVISOR'S NAME: Natalie Dunaway	TELEPHONE: (916) 584-3508
LICENSING EVALUATOR NAME: Erwina Pascual-Golamco	TELEPHONE: (916) 206-1524
LICENSING EVALUATOR SIGNATURE:	DATE: 05/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2023

LIC809 (FAS) - (06/04)

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