343601750-2-21-2020-03-CC-ESIA-BLZPEZ-20200221101559

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343601750
Report Date: 02/21/2020
Date Signed: 02/21/2020 10:16:04 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:	CHARLES E. MACK PRESCHOOL		FACILITY NUMBER:	343601750
ADMINISTRATOR:	COLLIER, ROBERTA		FACILITY TYPE:	850
ADDRESS:	4701 BROOKFIELD DRIVE		TELEPHONE:	(916) 422-1566
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95823
CAPACITY:	72	CENSUS: 17	DATE:	02/21/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	08:00 AM
MET WITH:	Gregory P smith		TIME COMPLETED:	10:15 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 (LPA) Elvira Sierra met with Lead teacher, Gregory P. Smith for the purpose of an unannounced annual random inspection. Census included 17 preschool children supervised by 4 staff members who all have obtained a criminal record clearance through Elk Grove Unified School District. Facility operates in the school ground of the Charles Mack Elementary in Portable B1 .Facility is State and Federal (Head Start) funded. Facility offers two sessions; M-F (State) from 8:00 AM-11:00 AM and M-Th (Head Start) from 11:45 AM to 03:15 PM. Children do not take naps at the facility. The facility offers breakfast for the morning session and lunch and a PM snack for the afternoon session. Food is prepared in the Charles Mack Campus centralized kitchen. LPA toured all activity and classroom spaces, restrooms and outdoor play areas. Lead Teacher stated there are no poisons, bodies of water 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 wood chips to absorb fall. Toileting facilities are in safe, sanitary and operating condition. The floors appeared clean throughout the facility. Menus were posted and drinking water was readily available to children both indoors and outdoors. LPA observed full legal signatures while reviewing the sign in and sign out sheet. Staff and 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. Report continues on subsequent page 809C----

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Elvira Sierra	TELEPHONE: (916) 216-8826
LICENSING EVALUATOR SIGNATURE:	DATE: 02/21/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2020

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: CHARLES E. MACK PRESCHOOL	FACILITY NUMBER: 343601750
	VISIT DATE: 02/21/2020

NARRATIVE

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All staff currently employed with the facility have a health screening report. LPA verified documentation of the educational background, training, and/or experience. LPA reminded Lead Teacher that 100% supervision is required at all times, including in the bathroom. LPA observed a functional carbon monoxide detector. LPA reviewed the Department's inspection authority.

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: www.ada.gov/childqanda.

LPA reviewed AB 1207- Mandated Reporter Training. The licensee must complete the training every two years starting January 1, 2018 and retain proof of completion in the facility file. The training can be could at: mandatedreporterca.com. Lead Testing for Drinking Water and Lead Poisoning Facts information were provided to Lead teacher.

LPA verified the annual fees are current.

This facility evaluation report was reviewed and discussed with Lead Teacher; A Notice of Site Visit was provided and should remain posted for a period of 30 days for parental review. LPA provided the Child Care Advocates Program email address: childcareadvocatesprogram@dss.ca.gov, so Lead Teacher can request to be added to the distribution list to receive Quarterly Updates. Facility was encouraged to visit the department's website at WWW.CCLD.CA.GOV for information regarding child care updates, forms, regulations and legislation

***No deficiencies cited against the facility under CCR,Title 22, Div. 12, Chapt. 1.***

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Elvira Sierra	TELEPHONE: (916) 216-8826
LICENSING EVALUATOR SIGNATURE:	DATE: 02/21/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2020

LIC809 (FAS) - (06/04)

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