343604409-4-21-2022-03-CC-KGUA-CDPTNJ-20220421145248

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343604409
Report Date: 04/21/2022
Date Signed: 04/21/2022 02:53:03 PM

Document Has Been Signed on 04/21/2022 02:53 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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME:	SAN JUAN EARLY HEAD START		FACILITY NUMBER:	343604409
ADMINISTRATOR:	DEBRA MCMANNIS		FACILITY TYPE:	830
ADDRESS:	7551 GREENBACK LANE		TELEPHONE:	(916) 728-3109
CITY:	CITRUS HEIGHTS	STATE: CA	ZIP CODE:	95610
CAPACITY:	42	CENSUS: 8	DATE:	04/21/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:15 AM
MET WITH:	Yelena Dorozhko		TIME COMPLETED:	03:00 PM

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At 11:15 a.m., on Thursday, April 21st, 2022, Licensing Program Analyst (LPA) Karyn Guerra met with Staff, Yelena Dorozhko, for the purpose of a 1 year- required inspection. Census consisted of 5 infant children supervised by 3 staff, and 3 toddler children supervised by 2 staff. Hours of operation are from 7:30 a.m. – 3:30 p.m., Monday thru Friday.

Criminal Background clearance is on file with the school district. Staff 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.

LPA conducted a health and safety inspection of the classroom, restrooms, and food service areas. LPA observed the following documents are posted: License, Emergency Disaster Plan, Personal Rights, Parents' Rights Poster, car seat laws, menus, and daily schedule. Cleaning disinfectants and hazardous items are appropriately stored and inaccessible to children. Staff stated that there are no firearms nor poisons on the premises. LPA observed a changing table within arm's reach of a sink. Changing table has raised sides. Bins for solid waste have tight fitting lids. The floors appeared clean throughout the facility. Facility provides formula for infant children. LPA observed prepared milk bottles labeled with children's names. Other food in the facility was properly stored to prevent contamination. Drinking water is provided to children via labeled water bottles. LPA observed sign in and sign out logs with full legal signature of parent/guardians.

No children in care require medications. Incidental Medical Services – IMS was discussed. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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.

SUPERVISOR'S NAME: Seychelle De Luca	TELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Karyn Guerra	TELEPHONE: (916) 216-7790
LICENSING EVALUATOR SIGNATURE:	DATE: 04/21/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/21/2022

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: SAN JUAN EARLY HEAD START	FACILITY NUMBER: 343604409
	VISIT DATE: 04/21/2022

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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. LPA 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. Staff understands that an individual infant sleeping plan LIC9227 must be on file for all infants up to 12 months of age. Napping infant child under 12 months was observed to be placed on their back without any loose articles in the crib. Napping logs were observed.

LPA conducted a health and safety inspection of the outdoor space. Playground equipment and surfaces were free of loose or sharp parts. LPA observed wood chips to provide cushioning. Outdoor shade was provided by trees. Water is accessible via cups.

LPA reviewed staff and children's records. Each child's file contained an admission agreement, emergency card, health history, immunizations, and acknowledgement of receipt of personal rights, consent for emergency medical treatment, and parent’s rights. LPA observed CPR and First aid certification for at least one staff on the facility premises. LPA observed health screening, staff immunization records. Staff were reminded to have current AB 1207 Mandated Reporter training certificates in facility files. LPA observed employee rights, and documentation of the educational background, training, and/or experience.

A staff interview was conducted with Staff, Yelena Dorozhko.

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.

In the areas that were evaluated, no deficiencies were cited during today’s inspection. Exit interview conducted and report was reviewed with the Staff, Yelena Dorozhko. A notice of site visit was given and must remain posted for 30 days.

SUPERVISOR'S NAME: Seychelle De Luca	TELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Karyn Guerra	TELEPHONE: (916) 216-7790
LICENSING EVALUATOR SIGNATURE:	DATE: 04/21/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/21/2022

LIC809 (FAS) - (06/04)

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