343600517-10-29-2024-03-CC-MGON-DAHRSF-20241029131640

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343600517
Report Date: 10/29/2024
Date Signed: 10/29/2024 01:16:50 PM

Document Has Been Signed on 10/29/2024 01:16 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME:	GARFIELD STATE PRESCHOOL & HEAD START		FACILITY NUMBER:	343600517
ADMINISTRATOR/ DIRECTOR:	JANET SCHWARTZ-EDMISTEN		FACILITY TYPE:	850
ADDRESS:	3700 GARFIELD AVENUE		TELEPHONE:	(916) 575-2349
CITY:	CARMICHAEL	STATE: CA	ZIP CODE:	95608
CAPACITY: 68	TOTAL ENROLLED CHILDREN: 68	CENSUS: 30	DATE:	10/29/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	11:00 AM
MET WITH:	Shannon Jaraba		TIME VISIT/ INSPECTION COMPLETED:	01:45 PM

NARRATIVE

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On Tuesday October 29th 2024, Licensing Program Analyst (LPA) Mandie Goodwin met with Facility Representative Shannon Jaraba for the purpose of an unannounced random inspection. Facility had classrooms operating in rooms K-A and K-B. LPA toured the facility at which time a census of 30 preschool children supervised by 4 staff members were observed.

A health and safety inspection was conducted in the classrooms, restrooms, food service area, and outdoor play area. LPA observed all postings. Cleaning disinfectants and hazardous items are appropriately stored and inaccessible to children. Furniture and equipment are in good condition, and toileting facilities are in sanitary and operating condition. There are bins for solid waste. The floors appeared clean throughout the facility. LPA observed functional smoke and carbon monoxide detectors, and a fire extinguisher. Nap equipment was stored appropriately with bedding separated. LPA observed a current roster, documentation of sign in and sign outs through a digital application, and documentation that facility is conducting emergency disaster drills at least every 6 months.

Children have access to water indoors and outdoors by bringing water bottles which are refilled. Playground equipment and surfaces were inspected and are in good condition with enough resilient material under climbing structures to absorb a fall. Outdoor shade is provided by canopies, trees, and sides of buildings. There are no firearms or bodies of water on the premises.

LPA reviewed staff files. At least one staff member present today has current Pediatric CPR and First Aid certification. LPA observed immunization records and documentation of the educational background, training, and/or experience. Upon review, all staff members had current mandated reporter trainings. LPA advised AB 1207 Mandated Reporter training must be renewed every two years and can be renewed at www.mandatedreporterca.com (Report continues 809-C)

Seychelle De Luca	TELEPHONE: (916) 263-5719
Mandie Goodwin	TELEPHONE: (916) 639-2867
	DATE: 10/29/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/29/2024

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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Document Has Been Signed on 10/29/2024 01:16 PM - 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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: GARFIELD STATE PRESCHOOL & HEAD START	FACILITY NUMBER: 343600517
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/29/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101216(g)(1)

Personnel Requirements

(1) Except as specified in (3) below, good physical health shall be verified by a health screening, including a test for tuberculosis, performed by or under the supervision of a physician not more than one year prior to or seven days after employment or licensure. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on documentation review, the licensee did not comply with the section cited above in 3 out of 4 staff files reviewed were either missing the health screening or TB test results which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 11/22/2024
	Plan of Correction
1 2 3 4	Facility will ensure all staff have the LIC503 or similar health screening conducted by a physician and documentation of TB test results. Facility will send missing forms to LPA Goodwin by the plan of correction date.

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 Luca	TELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Mandie Goodwin	TELEPHONE: (916) 639-2867
LICENSING EVALUATOR SIGNATURE:	DATE: 10/29/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/29/2024

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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: GARFIELD STATE PRESCHOOL & HEAD START	FACILITY NUMBER: 343600517
	VISIT DATE: 10/29/2024

NARRATIVE

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A sample of 5 children's records were reviewed. Each child's file contained an emergency card, consent for emergency medical treatment, health history, a record of immunization’s and notifications of children’s and parent’s rights.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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 reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

LPA referred licensee to the Department website for lead. Lead Toxicity Prevention and Water Testing Information- https://www.cdss.ca.gov./inforesources/child-care-licesing/water-testing-information.

LPA discussed the safe sleep regulations with Director 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. LPA also informed Director 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 Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

SUPERVISOR'S NAME: Seychelle De Luca	TELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Mandie Goodwin	TELEPHONE: (916) 639-2867
LICENSING EVALUATOR SIGNATURE:	DATE: 10/29/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/29/2024

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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: GARFIELD STATE PRESCHOOL & HEAD START	FACILITY NUMBER: 343600517
	VISIT DATE: 10/29/2024

NARRATIVE

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Director was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Exit interview conducted and report was reviewed with the Facility Representative Shannon Jaraba. Based on the areas evaluated, title 22 deficiencies were cited today. A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. Appeal rights were provided.

SUPERVISOR'S NAME: Seychelle De Luca	TELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Mandie Goodwin	TELEPHONE: (916) 639-2867
LICENSING EVALUATOR SIGNATURE:	DATE: 10/29/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/29/2024

LIC809 (FAS) - (06/04)

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