343615108-5-5-2023-03-CC-ASUR-CRJS5C-20230505133406

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343615108
Report Date: 05/05/2023
Date Signed: 05/05/2023 01:34:32 PM

Document Has Been Signed on 05/05/2023 01:34 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:	WOODRIDGE PRESCHOOL CENTER		FACILITY NUMBER:	343615108
ADMINISTRATOR:	MAI VANG		FACILITY TYPE:	850
ADDRESS:	5950 REVELSTOK DRIVE		TELEPHONE:	(916) 566-1650
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95842
CAPACITY: 94	TOTAL ENROLLED CHILDREN: 110	CENSUS: 57	DATE:	05/05/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Mai Vang		TIME COMPLETED:	11:30 AM

NARRATIVE

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On Friday, May 5, 2023, Licensing Program Analyst (LPA) Amanda Sutter met with Site Supervisor Mai Vang for the purpose of an unannounced required annual inspection. ECE Coordinator Nicole Schlie was also present. LPA observed 14 children supervised by three staff in room 34, 9 children supervised by 2 staff on the playground, 17 children supervised by 3 staff in room 37, and 17 children supervised by 3 staff in room 36. All individuals subject to criminal background review have obtained a criminal record clearance. The facility hours of operation are Monday through Friday from 7:00 AM to 5:00 PM in classrooms 34 and 35, and 8:00 AM to 3:00 PM in classrooms 36 and 37.

LPA toured classroom spaces, restrooms, and outdoor play area. LPA observed the following documents are posted: License, Parents' Rights Poster, Seat Belt Law, Menu, Schedule, Earthquake Preparedness Checklist, Emergency Disaster Plan, and Lead Brochure. Cleaning disinfectants and hazardous items are appropriately stored and inaccessible to children. Director stated there are no poisons or firearms on the premises. Furniture and equipment are in good condition, and toileting facilities are in safe, sanitary, and operating condition. The program provides breakfast, lunch, and dinner. Food is prepared on the school campus.

LPA observed trash bins with tight fitted lids. LPA observed the facility’s electronic sign in and out system. Facility has record of conducting fire drills at least every six months. The last fire drill was conducted on April 13, 2023. In classroom 37, LPA observed both an Albuterol inhaler and an Epinephrine injector that had expired 4/21/2022. Playground equipment and surfaces are free of loose or sharp parts, and bark is present under the equipment to provide sufficient cushioning. There are sufficient equipment and toys, and shaded areas are supplied by a shade cloth. Drinking water is readily available to children both indoors and outdoors. LPA observed children’s water bottles, which ECE Coordinator stated are refilled at the facility using water jugs.
PAGE 1. REPORT CONTINUES ON LIC809-C

SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Amanda Sutter
LICENSING EVALUATOR SIGNATURE:	DATE: 05/05/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/05/2023

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: WOODRIDGE PRESCHOOL CENTER	FACILITY NUMBER: 343615108
	VISIT DATE: 05/05/2023

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Ten staff and seven children's records were reviewed. Both children’s files and staff files were observed to be complete. There is at least one staff member present with a current CPR certificate. LPA observed facility roster to be complete.

LPA discussed the safe sleep regulations with director and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPAS also informed director of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.Incidental Medical Service (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: http://www.ada.gov/childqanda.htm

Director 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.

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.

During today’s inspection, one type B deficiency was observed. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with Site Supervisor Mai Vang. Appeal rights were provided.

SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Amanda Sutter
LICENSING EVALUATOR SIGNATURE:	DATE: 05/05/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/05/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 05/05/2023 01:34 PM - It Cannot Be Edited

Created By: Amanda Sutter On 05/05/2023 at 11:14 AM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: WOODRIDGE PRESCHOOL CENTER	FACILITY NUMBER: 343615108
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/05/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101226(e)(2)

(e) In centers where the licensee chooses to handle medications: (2) All prescription and nonprescription medications shall be maintained with the child's name and shall be dated. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, two of the two prescription medications observed in room 37 had expired on 4/21/2022, which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 05/26/2023
	Plan of Correction
1 2 3 4	Facility will return expired medication to parent, and provide LPA with a signed receipt proving that the parent has received the medication. Director will discuss medication expiration with school nurse and will provide LPA with proof of conversation.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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:

Seychelle De Luca

LICENSING EVALUATOR NAME:

Amanda Sutter

LICENSING EVALUATOR SIGNATURE:

DATE: 05/05/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/05/2023

LIC809 (FAS) - (06/04)

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