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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343604450
Report Date: 02/11/2025
Date Signed: 02/11/2025 06:10:51 PM

Document Has Been Signed on 02/11/2025 06:10 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:SUNRISE KIDS CLUB OLIVE GROVEFACILITY NUMBER:
343604450
ADMINISTRATOR/
DIRECTOR:
BERNARDI, PATRICIAFACILITY TYPE:
840
ADDRESS:7926 FIRESTONE WAYTELEPHONE:
(916) 726-0224
CITY:ANTELOPESTATE: CAZIP CODE:
95843
CAPACITY: 120TOTAL ENROLLED CHILDREN: 120CENSUS: 30DATE:
02/11/2025
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:05 PM
MET WITH:Kourtney HobartTIME VISIT/
INSPECTION COMPLETED:
06:15 PM
NARRATIVE
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At 3:05pm on 2/11/2025, Licensing Program Analysts (LPAs) Loraine Perez and Matthew Gallo met with facility representative Kourtney Hobart to open and close a complaint investigation. Upon arrival, LPAs observed a census of 30 children supervised by 4 staff.

The complaint investigation was based on the allegation that facility was not kept free of hazards for children in care due the presence of mold in one of the classrooms. The complaint was substantiated. During the investigation, LPAs determined through interview, observation, and record review that mold was discovered in Classroom 3 on 1/30/2025. Classroom 3 was vacated the following day and left vacant as children in care were moved to the school's multipurpose room. On 2/6/2025, Classrooms 2 & 3 were also vacated to conduct testing for fungal materials, and all children were moved to either the multipurpose room or library. Neither area is licensed for the provision of day care services, and licensing was not made aware of the classroom closures or the move to the new areas. In addition, the multipurpose room and library are currently used by the school's extended learning (ELOP) program. During today's visit, LPAs observed daycare children and ELOP children comingling in the multipurpose room and library.

Title 22 deficiencies are cited on the accompanying 809-D.

Licensee acknowledges, that FOR TYPE A DEFICIENCIES ONLY upon receipt, licensee shall post LIC 809D with Type A deficiencies for 30 days and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. LIC 9224 must be signed by parents/guardians and kept with the children's forms as a receipt whenever any Type A documents are provided by the licensee. LIC 9224 and Appeal Rights were provided.

Exit interview conducted and report was reviewed with the facility representative, Kourtney Hobart. A notice of site visit was given and must remain posted for 30 days.
Mai LorTELEPHONE: (916) 263-5728
Matthew GalloTELEPHONE: (916) 208-3734
DATE: 02/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/11/2025
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 02/11/2025 06:10 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: SUNRISE KIDS CLUB OLIVE GROVE

FACILITY NUMBER: 343604450

DEFICIENCY INFORMATION FOR THIS PAGE:

VISIT DATE: 02/11/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/12/2025
Section Cited
CCR
101538.3b

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In combination programs, indoor activity space provided for school-age child care center children shall be physically separated from space provided for infant care and child care center children.
This requirement is not met as evidenced by:

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Licensee will request to use of other rooms on the elementary school campus and submit an updated LIC200 by the plan of correction due date.
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Based on observation and interview, the licensee did not comply with the section cited above due to daycare children and the school's separate ELOP program comingling in the multipurpose and library since at least 2/6/2025. This poses an immediate health, safety, or personal rights risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Mai LorTELEPHONE: (916) 263-5728
Matthew GalloTELEPHONE: (916) 208-3734

DATE: 02/11/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/11/2025

LIC809 (FAS) - (06/04)
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Document Has Been Signed on 02/11/2025 06:10 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: SUNRISE KIDS CLUB OLIVE GROVE

FACILITY NUMBER: 343604450

DEFICIENCY INFORMATION FOR THIS PAGE:

VISIT DATE: 02/11/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/21/2025
Section Cited
CCR
101161(a)

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A license shall not operate a child care center beyond the conditions and limitations specified on the license, including the capacity limitations.

This requirement was not met as evidenced by:
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Licensee will request to use of other rooms on the elementary school campus by submitting an updated LIC200 by the plan of correction due date.
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Based on observation and interview, the facility did not comply with the section above due to LPA determining that, since 2/6/2025, the facility has moved children from the licensed classrooms to the school's multipurpose and library, which are not licensed areas for the provision of child care. This poses a potential health, safety, or personal rights to persons in care
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Type B
02/11/2025
Section Cited
CCR101212(d)

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Upon the occurrence, during the operation of the child care center of any of the events specified in (d)(1) below, a report shall be made to the Department by telephone or fax within the Department's next working day and during its normal business hours.

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Licensee will submit an unusual incident report regarding this event by the plan of correction date. Moving forward Licensee stated they will continue to follow reporting requirements.
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Based on observation, interview, and record review, the licensee did not comply with the section cited above due to not reporting the facility vacating classrooms due to the presence of mold. This poses a potential health, safety, or personal rights risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Mai LorTELEPHONE: (916) 263-5728
Matthew GalloTELEPHONE: (916) 208-3734

DATE: 02/11/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/11/2025

LIC809 (FAS) - (06/04)
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