340321340-11-29-2022-03-CC-JGAG-CLMQ9A-20221129105800

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 340321340
Report Date: 11/29/2022
Date Signed: 11/29/2022 10:58:18 AM

Document Has Been Signed on 11/29/2022 10:58 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
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: 18	DATE:	11/29/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Denise Richardson		TIME COMPLETED:	11:10 AM

NARRATIVE

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On November 29, 2022 at approximately 9:15 AM, Licensing Program Analyst (LPA) Josiah met with Director Denise Richardson for the purpose of an unannounced annual random inspection. Census included 18 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.

LPA toured classroom L3, restrooms, and outdoor play area. Medications are appropriately stored and inaccessible to children. Director stated there are no weapons or 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. Facility requires paper and digital sign-in from parents/guardians.

Three staff and five 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. 11/20/23). All staff currently employed have a criminal record clearance through the school district and documentation of educational background, training, and/or experience. LPA reminded Director that 100% supervision is required at all times, including in the bathroom. LPA 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.

Report continues on 809-C...

SUPERVISOR'S NAME: Seychelle De Luca	TELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Josiah Gathing	TELEPHONE: (916) 799-9668
LICENSING EVALUATOR SIGNATURE:	DATE: 11/29/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/29/2022

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: FATHER KEITH B. KENNY PRESCHOOL	FACILITY NUMBER: 340321340
	VISIT DATE: 11/29/2022

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Incidental Medical Services (IMS) policy was discussed.This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. 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/inspection-process.

Director was encouraged to the visit the Department's website at WWW.CCLD.CA.GOV for information regarding child care updates, PINs, forms, regulations and legislation pertaining to child care centers.

No deficiencies were cited based on today’s inspection. Exit interview was conducted and report was reviewed with the Facility Representative. A notice of site visit was given and must remain posted for 30 days.

SUPERVISOR'S NAME: Seychelle De Luca	TELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Josiah Gathing	TELEPHONE: (916) 799-9668
LICENSING EVALUATOR SIGNATURE:	DATE: 11/29/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/29/2022

LIC809 (FAS) - (06/04)

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