<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343610146
Report Date: 05/22/2023
Date Signed: 05/22/2023 02:43:35 PM


Document Has Been Signed on 05/22/2023 02:43 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
RIVER CITY (SACTO)CC, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833



FACILITY NAME:4TH R - WITTER RANCHFACILITY NUMBER:
343610146
ADMINISTRATOR:THAO, CHENGFACILITY TYPE:
840
ADDRESS:3790 POPPY HILL WAYTELEPHONE:
(916) 566-1559
CITY:SACRAMENTOSTATE: CAZIP CODE:
95834
CAPACITY:130CENSUS: 15DATE:
05/22/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:20 PM
MET WITH:Cheng ThaoTIME 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
At 1:20 PM on Monday May 22nd, 2023 Licensing Program Analyst (LPA) Mandie Goodwin and Licensing Program Manager (LPM) Seychell De Luca met with Director Cheng Thao , for the purpose of an unannounced 1 year required inspection. Facility operates in portable rooms 1&2 and used usage of portables P1, P8 , and multipurpose room. Facility provides supper/snack and an afternoon snack. LPA toured the facility, at which time a census of 15 children supervised by 5 staff was observed. All individuals subject to criminal record review have obtained criminal record clearance.

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, required publications, menus, and daily schedules. Cleaning disinfectants and hazardous items are appropriately stored and inaccessible to children. Medications are stored out of reach and inaccessible to children. Furniture and equipment are in good condition, and toileting facilities are in sanitary, and operating condition. Bins for solid waste have tight fitting lids. The floors appeared clean throughout the facility. LPA observed smoke and carbon monoxide detectors.

Children have access to water indoors and outdoors using water bottles and drinking fountains. Facility has conducted the required lead testing for consumable water sources. Playground equipment and surfaces are free of loose or sharp parts. LPA observed sufficient cushioning under play structures. Outdoor shade is provided by canopies over tables and sides of buildings. There are no firearms or bodies of water on the premises. Director stated there are no poisons on the premises.

LPA reviewed staff files. At least one staff member present today has current Pediatric CPR and First Aid certification. LPA observed immunization records and documentation of the educational background, training, and/or experience. Upon review, all staff members had current mandated reporter trainings.

Report Continues on 809-C

SUPERVISOR'S NAME: Seychelle De LucaTELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Mandie GoodwinTELEPHONE: (916) 639-2867
LICENSING EVALUATOR SIGNATURE:
DATE: 05/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/22/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVER CITY (SACTO)CC, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME: 4TH R - WITTER RANCH
FACILITY NUMBER: 343610146
VISIT DATE: 05/22/2023
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
26
27
28
29
30
31
32
LPA advised AB 1207 Mandated Reporter training must be renewed every two years and can be renewed at www.mandatedreporterca.com. Facility had a current roster. Facility was reminded that fire drills must be conducted every 6 months.

A sample of 5 children's records were reviewed. Each child's file contained an emergency card, consent for emergency medical treatment, health history, a record of immunization’s and notifications of children’s and parent’s rights. LPA provided the Community Care Licensing’s website www.ccld.ca.gov, so the director can obtain updated licensing information, new regulations and access forms. LPA advised director of their responsibility to stay current in regards to new regulations.

Facility representative 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.

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.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



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

NO TITLE 22 DEFICIENCIES CITED TODAY. Exit interview was conducted and report was reviewed with Director Cheng Thao. A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISOR'S NAME: Seychelle De LucaTELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Mandie GoodwinTELEPHONE: (916) 639-2867
LICENSING EVALUATOR SIGNATURE:

DATE: 05/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2023
LIC809 (FAS) - (06/04)
Page: 2 of 2