343605845-9-11-2019-03-CC-KFEA-BFWSEJ-20190911134851

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343605845
Report Date: 09/11/2019
Date Signed: 09/11/2019 01:48:57 PM

COMPREHENSIVE INSPECTION

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:	THEODORE JUDAH		FACILITY NUMBER:	343605845
ADMINISTRATOR:	BARGER, SABRINA		FACILITY TYPE:	850
ADDRESS:	101 DEAN WAY ROOM #19		TELEPHONE:	(916) 983-4469
CITY:	FOLSOM	STATE: CA	ZIP CODE:	95630
CAPACITY:	30	CENSUS: 13	DATE:	09/11/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Jacqueline Wyse		TIME COMPLETED:	02:00 PM

NARRATIVE

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Licensing Program Analyst (LPA) Kelly Ferrara met with the Coordinator of Early Childhood, Jacqueline Wyse for the purpose of an unannounced random annual inspection. LPA toured the classroom including all activity and classroom spaces, restrooms, kitchen area, and outdoor play area. All staff receive fingerprint clearance through the school district. Appropriate ratio and care and supervision were observed during today's inspection. Census included 13 preschool children being supervised by two staff and the Director. Coordinator was reminded never to exceed the conditions, limitations and capacity specified on the license. The facility operates according to the Folsom Cordova School District schedule and has a morning and afternoon program. The morning program operates Monday through Friday 8:15 am to 11:15 am and the afternoon program is 11:45 am to 2:45 pm.

The program provides a breakfast and lunch; and both meals are prepared in the school cafeteria. The morning children receive breakfast and the afternoon children receive lunch upon arrival. Menus were posted as well as Parents Rights, Personal Rights, Carseat laws, Emergency Disaster Plan, and Activities Calendar. The classroom appeared clean and in good repair and the playground equipment and surfaces were inspected and safe. The areas around or under the climbing equipment are cushioned with a resilient material to absorb a fall and there is adequate shade. Uncontaminated drinking water was readily available to children both indoors and outdoors. Bathrooms were clean and all sinks and toilets were in operating condition. The classroom has a combination smoke and carbon monoxide detector that was tested and is functioning. LPA observed a cubby available for each child and two separate binders for the parents to sign their children in and out of the facility.

A sample of children and staff files were reviewed. All children and staff files contained the required documentation. At least one staff present today has current Pediatric CPR and First Aid certification that expires in August 2021. LPA observed a current children's roster and a fire drill was conducted on August 27th, 2019.

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Kelly Ferrara	TELEPHONE: (916) 425-5932
LICENSING EVALUATOR SIGNATURE:	DATE: 09/11/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2019

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: THEODORE JUDAH	FACILITY NUMBER: 343605845
	VISIT DATE: 09/11/2019

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LPA observed that all staff had completed a training through Works International regarding Mandated Reporting. LPA learned that the Coordinator submitted a waiver for all school sites in the Folsom Cordova district to use this training in place of Mandatedreporterca.com

Incidental Medical Services (IMS) is provided by the facility. Medication is kept in the original packaging and staff have been trained. The facility has a first aid box with ample supplies. For additional IMS information, director was advised to 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.

This facility evaluation report was reviewed and discussed with the Coordinator. Coordinator 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. LPA gave the Coordinator a hand out on the Effects of Lead Exposure and a hand out on Active Supervision. A notice of site visit was provided and should remain posted for a period of 30 days for parental review.

Based on today's inspection, there were no deficiencies cited.

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Kelly Ferrara	TELEPHONE: (916) 425-5932
LICENSING EVALUATOR SIGNATURE:	DATE: 09/11/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2019

LIC809 (FAS) - (06/04)

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