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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343600801
Report Date: 01/24/2022
Date Signed: 01/24/2022 11:41:40 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:SETA - LAVERNE STEWART - HEAD STARTFACILITY NUMBER:
343600801
ADMINISTRATOR:KATHY BARNESFACILITY TYPE:
850
ADDRESS:5545 SKY PARKWAYTELEPHONE:
(916) 563-5055
CITY:SACRAMENTOSTATE: CAZIP CODE:
95823
CAPACITY:20CENSUS: 7DATE:
01/24/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Kathy BarnesTIME COMPLETED:
12:00 PM
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Licensing Program Analyst (LPA) Gagandeep Singh met with the director, Kathy Barnes, for an annual inspection. Purpose of the inspection was explained. Present, there are seven children in care with one teacher and the director. Facility is operating with in the capacity and in compliance with staff child ratio on this day. Facility operate day care from Monday to Friday between 8 AM to 2:30 PM.

With director, LPA inspected the day care areas including the classroom, Bathroom and Play yard. There are no pools, spas or other bodies of water at the facility. Facility has smoke detector, carbon detector, fully charged fire extinguisher and working telephone at the site. All of the cleaning solutions, poisons and other chemicals that are dangerous to the children are stored inaccessible to the children. Facility has age appropriate furniture. Furniture is steady and in good repair. Facility has sufficient amount of sleeping matts. Facility floor is in good repair and free of any hazards. All toilets, hand washing facilities are in working condition with proper sanitation in place. All storage containers for solid waste and in good repair and have proper lid on top. Facility has drinking water available for children. Play yard is free of hazards. All of the play structures are steady, in good repair and free of any loose parts. There is sufficient amount of rubber material under the play structures to prevent any fall injuries. Per director, facility staff brings drinking water with them, while the children use the play yard.

LPA reviewed the facility records. LPA observed that facility has all of the required documents posted and are visible for public. Facility has well maintained roster available on site. LPA reviewed five random children's and all present staff's files. LPA observed facility has record of names, addresses and telephone numbers of each child's authorized representative. The facility conducts fire drills and has a log in place. Per log, the last drill was conducted on January 11, 2022.

See next page for continuation ......
SUPERVISOR'S NAME: Maria MayorgaTELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Gagandeep SinghTELEPHONE: (916) 216-7823
LICENSING EVALUATOR SIGNATURE:

DATE: 01/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2022
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 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: SETA - LAVERNE STEWART - HEAD START
FACILITY NUMBER: 343600801
VISIT DATE: 01/24/2022
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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

LPA review AB 1207 with the director. As of January 1, 2018 all staff is required to complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com. The facility is using Department’s approved vendor for the training. LPA observed the completion certificates in file.



LPA encourages the director to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates. Licensee can also email at childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list for the updates.

No deficiencies are cited today. The copy of this report is reviewed and provided to the director. Notice of site visit is posted and shall remain posted for next 30 days.
SUPERVISOR'S NAME: Maria MayorgaTELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Gagandeep SinghTELEPHONE: (916) 216-7823
LICENSING EVALUATOR SIGNATURE:

DATE: 01/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2022
LIC809 (FAS) - (06/04)
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