343605503-6-13-2019-03-CC-MLOR-BD4PPR-20190613112958

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343605503
Report Date: 06/13/2019
Date Signed: 06/13/2019 11:30:06 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:	WOODBINE CHILDREN'S CENTER		FACILITY NUMBER:	343605503
ADMINISTRATOR:	NAIRANGU, WANGUI		FACILITY TYPE:	850
ADDRESS:	2500 52ND AVENUE		TELEPHONE:	(916) 433-5318
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95822
CAPACITY:	24	CENSUS: 16	DATE:	06/13/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	10:04 AM
MET WITH:	Jill Hernandez		TIME COMPLETED:	11:45 AM

NARRATIVE

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Licensing Program Analysts (LPAs) Mai Lor and Seychelle De Luca met with Site Supervisor Jill Hernandez for the purpose of an annual random inspection. The program operates in Room 23. Upon arrival, LPAs observed 16 children and three staff on site. LPAs toured the building including all activity and classroom spaces, restrooms, food service and outdoor play areas. Appropriate ratio, care and supervision were observed during the visit. Site Supervisor was reminded never to exceed the conditions, limitations and capacity specified on the license. The pre-school hours of operation are Monday through Friday 8:00am to 2:30pm. The pre-school operates according to Sacramento City Unified School District (SCUSD) schedule.

LPAs observed that medications, toxic and hazardous items are all stored appropriately and 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 bark to absorb the fall. Toileting facilities are in safe and sanitary condition. The food preparation space is free of litter. All food was protected against contamination. Trash cans containing solid waste had lids. Drinking water was readily available to children both indoors and outdoors. Menus were posted and sign in/out sheets consisted of full legal signatures. A random sample of children and staff files were reviewed. Children's files contained emergency information and immunization records. At least one staff member present today has current Pediatric CPR and First Aid certification that expires 10/2019.

All staff currently employed with the facility have a criminal record clearance through the SCUSD. There are no firearms or bodies of water on the premises, and the facility has at least one functioning carbon monoxide detector.

SUPERVISOR'S NAME: Roxana Saravia	TELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Mai Lor	TELEPHONE: (916) 491-0182
LICENSING EVALUATOR SIGNATURE:	DATE: 06/13/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/13/2019

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: WOODBINE CHILDREN'S CENTER	FACILITY NUMBER: 343605503
	VISIT DATE: 06/13/2019

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This facility provides Incidental Medical Services- IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing 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.

In the areas that were evaluated, deficiency was observed at the time of the visit and cited on subsequent LIC 809. Notice of Site Visit was provided to Site Supervisor and licensee understands it must remain posted for 30 days. Appeal Rights were provided.

Exit interview conducted and this facility evaluation report was reviewed and discussed with the site supervisor. Site supervisor was encouraged to the visit the departments website at WWW.CCLD.CA.GOV for information regarding child care updates, forms, regulations and legislation pertaining to child care centers.

SUPERVISOR'S NAME: Roxana Saravia	TELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Mai Lor	TELEPHONE: (916) 491-0182
LICENSING EVALUATOR SIGNATURE:	DATE: 06/13/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/13/2019

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: WOODBINE CHILDREN'S CENTER	FACILITY NUMBER: 343605503
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/13/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 07/15/2019 Section Cited HSC 1596.8662(b)(1)	1 2 3 4 5 6 7	On or before March 30, 2018, a person who, on January 1, 2018, a licensed child care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter	1 2 3 4 5 6 7	Mandated reporter training is available at mandatedreporterca.com. Facility shall submit a written plan and ensure all staff providing care and supervision have received mandated reporter
	8 9 10 11 12 13 14	training...This requirement is not met as evidenced by: Based on record review, there were no mandated reporter training for staff providing care and supervision which poses a potential health, safety, or personal rights to persons in care.	8 9 10 11 12 13 14	training (AB 1207) to LPA by 7/15/19.
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Roxana Saravia	TELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Mai Lor	TELEPHONE: (916) 491-0182
LICENSING EVALUATOR SIGNATURE:	DATE: 06/13/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/13/2019

LIC809 (FAS) - (06/04)

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