343607148-4-10-2023-03-CC-GSIH-CQRTMF-20230410145105

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343607148
Report Date: 04/10/2023
Date Signed: 04/10/2023 02:51:09 PM

Document Has Been Signed on 04/10/2023 02:51 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:	WILLIAM DAYLOR HIGH SCHOOL CHILD CARE CENTER		FACILITY NUMBER:	343607148
ADMINISTRATOR:	KIMBERLY SMITH		FACILITY TYPE:	830
ADDRESS:	6131 ORANGE AVE.		TELEPHONE:	(916) 427-5428
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95823
CAPACITY:	16	CENSUS: 0	DATE:	04/10/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:15 PM
MET WITH:	Kimberly Smith		TIME COMPLETED:	03:00 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analyst (LPA) Gagandeep Singh met with Director, Kimberly Smith, for an unannounced annual inspection. Purpose of the inspection was explained. This facility operates at school site in Room 6. During inspection, no children were present. With director, LPA inspected the day care areas. 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. Facility appropriate cribs for children in care. Cribs are in good repair. Facility has diaper changing area with proper sanitization in place. LPA observed the facility has supplies of diapers and wipes for the infants in care. LPA reviewed the facility records. LPA observed that facility has sign in/out record with full legal signatures. Facility has license and other required documents posted and are visible for public. LPA observed facility has record of names, addresses and telephone numbers of each child's authorized representative. Facility director has record of valid CPR training until March 04, 2024. The director is aware that all staff is required to complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com. LPA observed the facility is using department approved vendor for the training and has the completion certificate on file. Per certificate, director's training is valid until August 11,2024. LPA observed the facility has fire drill log in place. Per log, last drill was conducted in April 2023. LPA discussed the safe sleep regulations with director and provide the copy of PIN 20-24-CCP See next page for continuation ............

SUPERVISOR'S NAME: Natalie Dunaway	TELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Gagandeep Singh	TELEPHONE: (916) 216-7823
LICENSING EVALUATOR SIGNATURE:	DATE: 04/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/10/2023

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: WILLIAM DAYLOR HIGH SCHOOL CHILD CARE CENTER	FACILITY NUMBER: 343607148
	VISIT DATE: 04/10/2023

NARRATIVE

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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 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 director. Notice of site visit is posted and shall remain posted for next 30 days.

SUPERVISOR'S NAME: Natalie Dunaway	TELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Gagandeep Singh	TELEPHONE: (916) 216-7823
LICENSING EVALUATOR SIGNATURE:	DATE: 04/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/10/2023

LIC809 (FAS) - (06/04)

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