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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343610196
Report Date: 10/07/2019
Date Signed: 10/07/2019 10:11:51 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:PARK VISTA SCHOOL, INCFACILITY NUMBER:
343610196
ADMINISTRATOR:MAUCH, ANNEFACILITY TYPE:
850
ADDRESS:1300 SUTTERVILLE RD.TELEPHONE:
(916) 456-0551
CITY:SACRAMENTOSTATE: CAZIP CODE:
95822
CAPACITY:47CENSUS: 32DATE:
10/07/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
07:45 AM
MET WITH:Anne MauchTIME COMPLETED:
10:15 AM
NARRATIVE
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Licensing Program Analyst (LPA) Mai Lor met with Co-Director Anne Mauch for the purpose of an unannounced annual random inspection. The Director was reminded never to exceed the conditions, limitations, and capacity specified on the license. Census included 32 preschool children supervised by five staff. Hours of operation are Monday through Friday from 7:00am to 5:30pm.

A tour of the facility was conducted inside and outside. The following areas are in compliance during the inspection. There are no bodies of water. Disinfectants, hazardous items and medications are inaccessible to children. Furniture and equipment are sufficient, age appropriate and in good repair. A current disaster drill log was observed with the last fire drill conducted and documented on September 2019. The playground equipment and outdoor activity space is maintained and in good condition. Wood barks are used as cushioning around the climbing equipment and level is sufficient to absorb a fall. Children's toilets, hand washing facilities are sanitary. Floors are clean and free of debris. The facility provides breakfast, lunch, and snacks in between. Food preparation area is clean. Food is protected from contamination, storage containers for solid waste are covered, and all food or beverages are stored in covered containers and labeled. Drinking water is available both indoors and outside. Menus are posted. The facility is in compliance with conditions and limitations specified on the license. Sign in/sign out have full legal signature and record of time of day. Staff subject to a criminal record clearance or exemption are associated to the facility. At least one staff member on site have a current Pediatric CPR/First Aid which expires 04/2020.

A random staff and children records were reviewed and contained all of the required documentation. LPA did not observed a carbon monoxide detector on site.

(Report continued on subsequent LIC 809)
SUPERVISOR'S NAME: Roxana SaraviaTELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Mai LorTELEPHONE: (916) 491-0182
LICENSING EVALUATOR SIGNATURE:

DATE: 10/07/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2019
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 3
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: PARK VISTA SCHOOL, INC
FACILITY NUMBER: 343610196
VISIT DATE: 10/07/2019
NARRATIVE
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LPA reminded Director that 100% supervision is required at all times, including in the bathroom. LPA reviewed the Department's inspection authority and discussed with designee any changes that may occur regarding the director or an employee acting in the director's absence must be reported to department within ten working days.

The facility is providing Incidental Medical Services. 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: www.ada.gov/childqanda.

Facility fees are current. LPA provided the facility with Effects of Lead Exposure brochure.



LPA provided the Community Care Licensing website www.ccld.ca.gov, so the licensee can obtain updated licensing information, new regulations and access forms. LPA advised licensee of their responsibility to stay current in regards to new regulations.

Title 22 deficiency cited on the subsequent pages of this report.
Licensee acknowledges, that FOR TYPE A DEFICIENCIES ONLY upon receipt, Licensee shall post LIC 809D with Type A deficiencies for 30 days and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. LIC 9224 must be signed by parents/guardians and kept with the children's forms as a receipt whenever any Type A documents are provided by the licensee. LIC 9224 and Appeal Rights were provided.

Exit interview conducted and this facility evaluation report was reviewed and discussed with the facility Director.
SUPERVISOR'S NAME: Roxana SaraviaTELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Mai LorTELEPHONE: (916) 491-0182
LICENSING EVALUATOR SIGNATURE:

DATE: 10/07/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2019
LIC809 (FAS) - (06/04)
Page: 2 of 3
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: PARK VISTA SCHOOL, INC
FACILITY NUMBER: 343610196
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/07/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/08/2019
Section Cited

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Every licensed child day care center shall have one or more carbon monoxide detectors in the facility that meet the standards established in Chapter 8...This requirement was not met as
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evidenced by: Based on observation, LPA did not observed a carbon monoxide detector, which poses an immediate health and safety risk to children in care.
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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 SaraviaTELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Mai LorTELEPHONE: (916) 491-0182
LICENSING EVALUATOR SIGNATURE:
DATE: 10/07/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/07/2019
LIC809 (FAS) - (06/04)
Page: 3 of 3