343614793-10-17-2019-03-CC-ESIA-BH2MJW-20191017093949

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343614793
Report Date: 10/17/2019
Date Signed: 10/17/2019 09:40:05 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:	WILLIAM DAYLOR		FACILITY NUMBER:	343614793
ADMINISTRATOR:	MARTENS, TOM		FACILITY TYPE:	850
ADDRESS:	6131 ORANGE AVENUE		TELEPHONE:	(916) 427-2637
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95823
CAPACITY:	24	CENSUS: 11	DATE:	10/17/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	08:05 AM
MET WITH:	Jeenifer Phanthavong		TIME COMPLETED:	09:40 AM

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Licensing Program Analyst (LPA) Elvira Sierra met with Lead Teacher, Jennifer Phanthavong for the purpose of an unannounced annual random inspection. Upon arrival no children were present. 11 children arrived later during the inspection and 2 staff were present. Program operates in the grounds of the William Daylor High School in classroom 5, M-Th from 08:30 AM to 12:00 PM. The program is a combination of Head Start and State Preschool (WRAP).

LPA toured all activity and classroom spaces, restrooms, food service, and outdoor play areas. Medications are appropriately stored and inaccessible to children. Toxic and hazardous items are inaccessible to children. Furniture and equipment are in good condition. Playground equipment and surfaces are free of loose or sharp parts. There is resilient material underneath climbing structures. Toileting facilities are in safe, sanitary and operating condition. The floors appeared clean throughout the facility. Program provides breakfast and lunch. Menus were posted and drinking water was readily available to children both indoors and outdoors. There are no firearms or bodies of water on the premises. Staff is reminded Site Supervisor that 100% supervision is required at all times, including in the bathroom.

Staff and children's records were reviewed. All staff currently employed have a criminal record clearance through the District. Staff has health screening report, and documentation of the educational background, training, and/or experience on file. At least one staff member present today has current Pediatric CPR and First Aid certification. LPA observed child’s admission agreement on children’s files. Full legal signatures and time was observed in sign in/out sheets.

Report continued on subsequent page 809C -----

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Elvira Sierra	TELEPHONE: (916) 216-8826
LICENSING EVALUATOR SIGNATURE:	DATE: 10/17/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2019

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: WILLIAM DAYLOR	FACILITY NUMBER: 343614793
	VISIT DATE: 10/17/2019

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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.

Effects of Lead exposure information was provided.

Facility was update on new immunization requirements from the Department of Public Health(CDHP) that will become effective July 1, 2019. Additional information and resources can be found on the https://www.shotsforschool.org website.

LPA verified the annual fees are current.

This facility evaluation report was reviewed and discussed with Lead Teacher. A Notice of Site Visit was provided and should remain posted for a period of 30 days for parental review. LPA provided the Child Care Advocates Program email address: childcareadvocatesprogram@dss.ca.gov, facility can request to be added to the distribution list to receive Quarterly Updates. Facility is encouraged to the visit the department's website at WWW.CCLD.CA.GOV for information regarding child care updates, forms, regulations and legislation pertaining child care centers. In the areas that were evaluated, no deficiencies were observed at the time of the visit

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Elvira Sierra	TELEPHONE: (916) 216-8826
LICENSING EVALUATOR SIGNATURE:	DATE: 10/17/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2019

LIC809 (FAS) - (06/04)

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