343608969-3-22-2022-03-CC-KGUA-CCRTNX-20220322145329

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343608969
Report Date: 03/22/2022
Date Signed: 03/22/2022 02:53:52 PM

Document Has Been Signed on 03/22/2022 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:	RALPH RICHARDSON PRESCHOOL		FACILITY NUMBER:	343608969
ADMINISTRATOR:	LESSARD, NOEL		FACILITY TYPE:	850
ADDRESS:	4848 COTTAGE WAY		TELEPHONE:	(916) 971-7411
CITY:	CARMICHAEL	STATE: CA	ZIP CODE:	95608
CAPACITY:	72	CENSUS: 36	DATE:	03/22/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:45 PM
MET WITH:	Lara Khan		TIME COMPLETED:	03:15 PM

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At 12:45 p.m. on Tuesday, March 22nd, 2022, Licensing Program Analyst (LPA) Karyn Guerra met with Site Supervisor, Lara Khan, for the purpose of an unannounced annual random inspection. Classroom #1 is a duration program operating from 8:45 a.m. to 3:15 p.m., Monday thru Friday. Classroom #2 is a Head Start class operating from 8:00 a.m. to 2:30 p.m. with a minimum day on Thursdays from 8:00 a.m. to 11:45 a.m. Classroom #3 is a Wrap program operating from 8:00 a.m. to 2:30 p.m., with a minimum day on Thursdays from 8:00 a.m-11:45 a.m. LPA observed a census of 11 napping children supervised by 3 staff in Room 3, 16 napping children supervised by 3 staff in Room 2, and 9 children supervised by 2 staff in Room 1.

Criminal record clearance is on file with San Juan Unified School District. Site Supervisor 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.

A health and safety inspection was conducted in the classrooms, restrooms, food service areas, and outdoor play areas. LPA observed the following documents are posted: License, Emergency Disaster Plan, Personal Rights, Parents' Rights Poster, menus, and daily schedule. Cleaning disinfectants and hazardous items are appropriately stored and inaccessible to children. Furniture and equipment are in good condition, and toileting facilities are in safe, sanitary, and operating condition. Bins for solid waste have tight fitting lids. The floors appeared clean throughout the facility. Facility provides meals to children.

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 Child Care Centers Sections 101173 and 101226.

Report continues on 809-C.

SUPERVISOR'S NAME: Seychelle De Luca	TELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Karyn Guerra	TELEPHONE: (916) 216-7790
LICENSING EVALUATOR SIGNATURE:	DATE: 03/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2022

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: RALPH RICHARDSON PRESCHOOL	FACILITY NUMBER: 343608969
	VISIT DATE: 03/22/2022

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There are functional water fountains indoors and outdoors. The facility is currently using individual labeled water bottles and paper cups as a best practice due to COVID-19. LPA observed full legal signatures while reviewing the sign in and sign out sheets. Playground equipment and surfaces are free of loose or sharp parts. LPA observed wood chip cushioning beneath the play structure. Outdoor shade is provided by canopies. There are no firearms or bodies of water on the premises. LPA observed a Carbon monoxide detector in room #3.

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 reviewed staff and children's records. Each child's file contained an admission agreement, emergency card, health history, immunization record, and acknowledgement of receipt for personal rights, consent for emergency medical treatment, and parent’s rights. LPA observed current EMSA approved CPR and First aid certification for most staff on the facility premises. LPA observed health screening, staff immunization records and current AB 1207 Mandated Reporter training certificates. LPA observed employee rights, and documentation of the educational background, training, and/or experience.

LPA verified that annual fees are current. A staff interview was conducted with Site Supervisor, Lara Khan.

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 Site Supervisor, Lara Khan. 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: 03/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2022

LIC809 (FAS) - (06/04)

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