<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 340321700
Report Date: 09/22/2022
Date Signed: 09/22/2022 11:31:08 AM


Document Has Been Signed on 09/22/2022 11:31 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:SETA - FRUITRIDGE COMMUNITY CTR HEADSTARTFACILITY NUMBER:
340321700
ADMINISTRATOR:CARMEN SALCEDOFACILITY TYPE:
850
ADDRESS:5746 40TH STREETTELEPHONE:
(916) 563-5020
CITY:SACRAMENTOSTATE: CAZIP CODE:
95824
CAPACITY:40CENSUS: 24DATE:
09/22/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Carmen SalcedoTIME 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
On Thursday, September 22, 2022 at 9:00 am, Licensing Program Analyst (LPA) Amanda Sutter met with Site Supervisor Carmen Salcedo for the purpose of an unannounced required annual inspection. LPA observed 28 children supervised by 5 staff. The facility hours of operation are Monday through Thursday from 8:00 AM to 2:30.

LPA toured classroom space, restroom, and outdoor play area. LPA observed the following documents are posted: License, Emergency Disaster Plan, Personal Rights, Parents' Rights Poster, menu, fire drill log, and seat belt law. Cleaning disinfectants, medications and hazardous items are appropriately stored and inaccessible to children. Site Supervisor stated there are no poisons or firearms on the premises. Furniture and equipment are in good condition, and toileting facilities are in safe, sanitary and operating condition. The program provides breakfast, lunch, and a snack. Food is provided daily by a distributor and prepared in the facility’s kitchen.

LPAs observed trash bins with tight fitted lids. LPA observed the facility’s electronic sign in and out system. Facility has record of conducting fire drills at least every six months; last fire drill was conducted in September 15, 2022. Playground equipment and surfaces are free of loose or sharp parts and bark is present under the equipment to provide sufficient cushioning. There are sufficient equipment and toys, and shaded areas are supplied by shade structures and trees.

On 8/20/2022, the facility tested water samples for lead. Two outlets water sampled indicated an Action Level Exceedance (ALE). These outlets are marked A and C on the facility sketch provided by the center. A correlates to the right-most drinking fountain in the restroom area and C correlates to the drinking fountain to the left of the entrance in the classroom. On 8/24/2022 the facility was notified that water levels were in exceedance of 5 parts per billion in the locations that were tested.
PAGE 1. REPORT CONTINUES ON LIC809-C

SUPERVISOR'S NAME: Seychelle De LucaTELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Amanda SutterTELEPHONE: (916) 261-8918
LICENSING EVALUATOR SIGNATURE:
DATE: 07/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/11/2022
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 4


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: SETA - FRUITRIDGE COMMUNITY CTR HEADSTART
FACILITY NUMBER: 340321700
VISIT DATE: 09/22/2022
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
Since notification, the water fountain (tap C) has been taped off not allowed for use. Site Supervisor stated that they do not use the drinking fountains in the restroom area and taped them off to prevent use while LPA was present. Site Supervisor stated that alternative water has been provided to children with cups which the facility fills up at the classroom sink. LPA observed that the sink being used for water has not been lead tested. Site Supervisor stated that she would use water from the kitchen instead and would arrange to get classroom sinks lead tested. LPA spoke with Licensee representative Betsy Uda regarding the Plan of Correction. Licensee representative stated that she would send maintenance to the center to disconnect all drinking fountain lines today, 9/22/2022. LPA informed Site Supervisor that Grant funding for testing and remediation is available referenced from Provider Information Notice (PIN) 21-04-CCP.

Five staff and five children's records were reviewed. Both children and staff files were observed to be complete. There is at least one staff member present with a current CPR certificate. LPA observed a functional carbon monoxide detector, smoke detector and fire extinguisher.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPAS also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Incidental Medical Service (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

PAGE 2. REPORT CONTINUES ON LIC809-C
SUPERVISOR'S NAME: Seychelle De LucaTELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Amanda SutterTELEPHONE: (916) 261-8918
LICENSING EVALUATOR SIGNATURE:

DATE: 09/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2022
LIC809 (FAS) - (06/04)
Page: 2 of 4
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: SETA - FRUITRIDGE COMMUNITY CTR HEADSTART
FACILITY NUMBER: 340321700
VISIT DATE: 09/22/2022
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
Site Supervisor 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.

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.

During today’s inspection, one type B citation was cited. Appeal rights were provided. A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with Site Supervisor Carmen Salcedo.
SUPERVISOR'S NAME: Seychelle De LucaTELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Amanda SutterTELEPHONE: (916) 261-8918
LICENSING EVALUATOR SIGNATURE:

DATE: 09/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2022
LIC809 (FAS) - (06/04)
Page: 3 of 4
Document Has Been Signed on 09/22/2022 11:31 AM - It Cannot Be Edited

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: SETA - FRUITRIDGE COMMUNITY CTR HEADSTART
FACILITY NUMBER: 340321700

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/22/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
WD
101700.3(b)(1)

101700.3 California Lead Action Level at Child Care Centers (b) Testing results with ... (1) A ... values of 5.5 ppb or greater shall be deemed an Action Level Exceedance. This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on record review, two faucets tested exceeded the allowed 5.5 ppb, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/14/2022
Plan of Correction
1
2
3
4
LPA observed drinking fountains to be taped off in order to prevent use. Site Supervisor stated that the facility will provide alternative water using pitchers filled in the facility's kitchen. Licensee representative stated that taps will be turned off on 9/22/2022 to prevent water flow. LPA to return to observe taps shut off.
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 LucaTELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Amanda SutterTELEPHONE: (916) 261-8918
LICENSING EVALUATOR SIGNATURE:
DATE: 09/22/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/22/2022
LIC809 (FAS) - (06/04)
Page: 4 of 4