340321340-9-12-2019-03-CC-MBED-BFXLRR-20190912085930

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 340321340
Report Date: 09/11/2019
Date Signed: 09/12/2019 08:59:42 AM

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:	FATHER KEITH B. KENNY PRESCHOOL		FACILITY NUMBER:	340321340
ADMINISTRATOR:	DENISE RICHARDSON		FACILITY TYPE:	850
ADDRESS:	3525 MARTIN LUTHER KING BL. #3		TELEPHONE:	(916) 277-6512
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95817
CAPACITY:	30	CENSUS: 13	DATE:	09/11/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	10:20 AM
MET WITH:	Denise Richardson		TIME COMPLETED:	11:45 AM

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 (LPAs) Marea Behvand and Seychelle De Luca met with Director Denise Richardson for the purpose of an unannounced annual random inspection. Director was reminded never to exceed the conditions, limitations and capacity specified on the license. Census included 13 preschool children supervised by Director and two staff members. Facility hours of operation are Monday through Thursday from 8:00 AM to 2:30 PM and Fridays from 8:00 AM to 11:00 AM.

LPAs toured classroom #3, restrooms, and outdoor play area. Medications are appropriately stored and inaccessible to children. Director stated there are no poisons 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 bark to absorb the fall. Toileting facilities are in safe, sanitary and operating condition. The floors appeared clean throughout the facility. Storage containers with solid waste have tight-fitting covers. Program provides breakfast, lunch, and afternoon snacks and all food is prepared in the cafeteria and brought over to the classroom. Menus were posted and drinking water was readily available to children both indoors and outdoors. LPAs observed full legal signatures while reviewing the sign in and sign out sheet as required for preschool age component.

Three staff and three children's records were reviewed. Each child's file contained an emergency card and a medical assessment. At least one staff member present today has current Pediatric CPR and First Aid certification (exp. 01/20/21). All staff currently employed have a criminal record clearance through the school district,

Report continues on 809-C.

SUPERVISOR'S NAME: Roxana Saravia	TELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Marea Behvand	TELEPHONE: (916) 216-7793
LICENSING EVALUATOR SIGNATURE:	DATE: 09/11/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2019

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 2

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: FATHER KEITH B. KENNY PRESCHOOL	FACILITY NUMBER: 340321340
	VISIT DATE: 09/11/2019

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
26
27
28
29
30
31
32

and documentation of the educational background, training, and/or experience. 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 reviewed the Department's inspection authority and discussed with designee any changes that may occur regarding the director or an employee acting in the director's absence must be reported to department within 10 working days.

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.

This facility evaluation report was reviewed and discussed with Teacher. A Notice of Site Visit was provided and should remain posted for a period of 30 days for parental review. Director was encouraged to the visit the Department's website at WWW.CDSS.CA.GOV for information regarding child care updates, forms, regulations and legislation pertaining child care centers.

In the areas that were evaluated, no deficiencies were observed at the time of the visit.

SUPERVISOR'S NAME: Roxana Saravia	TELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Marea Behvand	TELEPHONE: (916) 216-7793
LICENSING EVALUATOR SIGNATURE:	DATE: 09/11/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2019

LIC809 (FAS) - (06/04)

Page: 2 of 2