343614412-9-11-2019-03-CC-KGOL-BFWRYA-20190911132601

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343614412
Report Date: 09/11/2019
Date Signed: 09/11/2019 01:26:11 PM

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:	DEL PASO ELEMENTARY SCHOOL		FACILITY NUMBER:	343614412
ADMINISTRATOR:	ROES, HEATHER		FACILITY TYPE:	850
ADDRESS:	590 MOREY AVENUE		TELEPHONE:	(916) 643-8700
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95838
CAPACITY:	24	CENSUS: 3	DATE:	09/11/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	12:10 PM
MET WITH:	Heather Roses		TIME COMPLETED:	01:45 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) Kristal Goodell met with Site Supervisor Heather Roses, for an unannounced Annual Inspection. Later during inspection, Director Elizabeth Cunnion joined. The Facility’s hours of operation are Monday - Friday, 8:00am-2:45pm and is split into a morning class and afternoon class. LPA conducted a census of 3 children with director and aide. Staff obtained fingerprint clearances through the Twin River Unified School District. Facility is located on the Del Paso Elementary School campus in portable #20. LPA toured the facility inside and out. LPA also toured the food service area and restrooms located in each classroom. The Director stated that the facility provides breakfast, lunch and afternoon snack. LPA observed a current menu and activity schedule posted in the classroom. LPA observed that outdoor activity space, playground equipment and drinking water is made readily available to children both indoors and outdoors. LPA observed cleaning compounds are inaccessible to children. Director stated there are no firearms, poisons, bodies of water on the property. LPA observed a smoke detector and fire extinguisher 3A10BC in each classroom. LPA observed an emergency binder and documentation of emergency drills. LPA reviewed children files which included Physician's Report (701), Parents Rights (LIC995), Acknowledgement of Notification of Parents' Rights (LIC995) and Child's preadmission Health History (LIC702). LPA also reviewed staff's files and qualifications were reviewed. LPA observed that at least both staff member present have a current Pediatric CPR/First Aid and one expires 4/2021. Report continues on LIC 809-C

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Kristal Goodell	TELEPHONE: (916) 216-7798
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: DEL PASO ELEMENTARY SCHOOL	FACILITY NUMBER: 343614412
	VISIT DATE: 09/11/2019

NARRATIVE

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The Mandated Reporter Training. Beginning January 1, 2018, Health and Safety Code 1596.8662 requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Volunteers are encouraged but not required to take the training. In addition, effective January 1, 2018: Applicants must meet requirements as a precondition to licensure, existing licensees must meet requirements by March 30, 2018, new employees shall have 90 days from date of employment to complete training as required. This training requirement may be met by using the Department’s Office of Child Abuse Prevention (OCAP) online training modules. The OCAP modules are free of cost and available at: http://www.mandatedreporterca.com/.

LPA obtained the facility’s email address to enroll in Quarterly Updates. In addition, LPA provided the Community Care Licensing’s website www.ccld.ca.gov, so the director can obtain updated licensing information, new regulations, self-assessment guides, and access forms. LPA advised the director of their responsibility to stay current in regards to new regulations.

No Title 22 Deficiencies cited during the inspection. LPA reviewed report with the director and provided copies. An exist interview was conducted. The Notice of Site Visit issued and must remain posted for 30 days.

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Kristal Goodell	TELEPHONE: (916) 216-7798
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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