340320736-10-4-2019-03-CC-RPIS-BGMR6Z-20191004124533

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 340320736
Report Date: 10/04/2019
Date Signed: 10/04/2019 12:45:42 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:	POPPY PATCH-PHASE II		FACILITY NUMBER:	340320736
ADMINISTRATOR:	DOROTHEA JACKSON		FACILITY TYPE:	850
ADDRESS:	9645 BUTTERFIELD		TELEPHONE:	(916) 845-6033
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95827
CAPACITY:	60	CENSUS: 14	DATE:	10/04/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	11:10 AM
MET WITH:	Dorothea Jackson		TIME COMPLETED:	01:00 PM

NARRATIVE

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Licensing Program Analysts (LPAs) Rosie Pitts and Tanya Washington met with Director Dorothea Jackson for the purpose of an unannounced annual random inspection. Director was reminded never to exceed the conditions, limitations, and capacity specified on the license. Upon arrival LPAs observed 14 preschool children being supervised by 4 staff. All staff currently at the facility have criminal record clearances. Facility hours of operation are Monday through Friday from 5:45 AM to 6:00 PM.

LPAs toured all activity and classroom spaces, restrooms, food service, and outdoor play areas. Director stated there are no poisons or any children with medications on the premises. Toxic and hazardous items are inaccessible to children. Furniture and equipment are in good condition. Playground equipment and surfaces are free of loose or sharp parts. The areas around or under climbing equipment are cushioned with materials to absorb the fall. Toileting facilities are in safe, sanitary, and operating condition. LPAs observed sufficient napping equipment. The floors appeared clean throughout the facility. The food preparation space is free of litter. All food was protected against contamination. Trash cans containing solid waste had lids. Program provides breakfast, lunch and afternoon snack. Menus were posted and drinking water was readily available to children both indoors and outdoors. Facility utilizes electronic sign-in and out system, in case of power outage or system malfunction, facility utilizes a classroom roster for manual sign in and out. LPAs reminded Director that 100% supervision is required at all times, including in the bathroom. There are no firearms or bodies of water on the premises. LPAs observed a functional carbon monoxide detector.

Report Continued on 809-C

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Rosie Pitts	TELEPHONE: (916) 263-5744
LICENSING EVALUATOR SIGNATURE:	DATE: 10/04/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/04/2019

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: POPPY PATCH-PHASE II	FACILITY NUMBER: 340320736
	VISIT DATE: 10/04/2019

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A sample of children's records were reviewed. Each child's file contained an emergency card and a consent for medical treatment. A sample of staff records were reviewed. All staff present at the facility during the inspection has obtained a criminal record clearance. A health screening report, and documentation of educational background, training, and/or experience was verified. At least one staff member present today has current Pediatric CPR and First Aid training certification and expires 06/2021.

LPAs observed 4 incomplete staff files with missing Mandated Reporter Training. The OCAP modules are free of cost and available at: http://www.mandatedreporterca.com/ . Director understands that the mandated reporter training as well as CPR training must be completed every two years, and proof of completion must remain in the facility’s file.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing 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.

LPAs discussed and provided Safe Sleep in Child Care and Effects of Lead Exposure brochures. LPA advised Licensee to familiarize themselves and their facility with the new regulations. LPA provided the following link:http://www.cdss.ca.gov/inforesources/Community-Care-Licensing/subscribe for the Licensee to subscribe to the distribution list and receive Quarterly Updates.

Title 22 deficiencies cited on the attached LIC 809D. This facility evaluation report was reviewed and discussed with the licensee. A notice of site visit was issued and must remain posted for 30 days. Licensee acknowledged that a copy of this report will remain on file for a period of three years for public review upon request. Appeal Rights were also issued and discussed.

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Rosie Pitts	TELEPHONE: (916) 263-5744
LICENSING EVALUATOR SIGNATURE:	DATE: 10/04/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/04/2019

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: POPPY PATCH-PHASE II	FACILITY NUMBER: 340320736
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/04/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 11/04/2019 Section Cited	1 2 3 4 5 6 7	...a licensed child care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training... This requirement was not met as evidenced by:
	8 9 10 11 12 13 14	Upon review of 4 staff files, LPAs observed that no files contained mandated reporter training.	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: Rosie Pitts	TELEPHONE: (916) 263-5744
LICENSING EVALUATOR SIGNATURE:	DATE: 10/04/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/04/2019

LIC809 (FAS) - (06/04)

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