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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343601750
Report Date: 01/26/2022
Date Signed: 01/26/2022 11:46:11 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 PRESCHOOLFACILITY NUMBER:
343601750
ADMINISTRATOR:COLLIER, ROBERTAFACILITY TYPE:
850
ADDRESS:4701 BROOKFIELD DRIVETELEPHONE:
(916) 422-1566
CITY:SACRAMENTOSTATE: CAZIP CODE:
95823
CAPACITY:72CENSUS: 0DATE:
01/26/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Sheiba SultaniTIME COMPLETED:
12:00 PM
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Licensing Program Analyst (LPA) Gagandeep Singh met with facility representative, Sheiba Sultani, for an annual inspection. Purpose of the inspection was explained. This facility operates at a school site from portable B1. All staff have criminal background clearance through school district. There are no children present during the inspection. Facility operate day care from Monday to Friday between 8 AM to 11 PM and from Monday to Thursday 11:45 AM to 3:15 PM.

During today’s inspection, LPA inspected the day care classroom, bathroom and play yard. There are no pools, or other bodies of water at the facility. Facility has smoke detector, carbon monoxide 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. 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. All the materials and surface accessible to the children is clean and toxic free. All the food is stored in properly manner and has lid to avoid any contamination. There is allergy list posted next to the regrigrator. Play yard is free of hazards.

LPA reviewed the facility records and 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 staff records and observed that staff members have record of valid CPR card on file. Facility has well maintained children roster on file. The facility has fire and emergency drill log and per log, last drill was conducted in December 2021.

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SUPERVISOR'S NAME: Maria MayorgaTELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Gagandeep SinghTELEPHONE: (916) 216-7823
LICENSING EVALUATOR SIGNATURE:

DATE: 01/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2022
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: CHARLES E. MACK PRESCHOOL
FACILITY NUMBER: 343601750
VISIT DATE: 01/26/2022
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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 reminded that staff that all staff is required to complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com.



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 facility representative. 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: 01/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2022
LIC809 (FAS) - (06/04)
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