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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343616384
Report Date: 10/03/2019
Date Signed: 10/03/2019 10:00:26 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:JAMES A. MCKEE ELEMENTARY SCHOOLFACILITY NUMBER:
343616384
ADMINISTRATOR:JACKSON, BRENDAFACILITY TYPE:
850
ADDRESS:8701 HALVERSON DRIVETELEPHONE:
(916) 686-3715
CITY:ELK GROVESTATE: CAZIP CODE:
95624
CAPACITY:24CENSUS: 23DATE:
10/03/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Brenda JacksonTIME COMPLETED:
10:10 AM
NARRATIVE
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Licensing Program Analysts (LPAs) Amy Silva and Seychelle De Luca met with Site Supervisor Brenda Jackson for the purpose of an unannounced annual random inspection. Site Supervisor was reminded never to exceed the conditions, limitations, and capacity specified on the license. Upon arrival, LPAs observed 23 preschool children supervised by Site Supervisor and two staff members. Facility hours of operation are Monday through Friday from 7:45 AM to 10:45 AM.

LPAs toured all activity and classroom spaces, restrooms, and outdoor play area. There are currently no children who require medication. Site Supervisor stated there are no poisons on the premises. 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. The areas around or under climbing equipment are cushioned with pour in rubber to absorb the fall. Toileting facilities are in safe, sanitary, and operating condition. The floors appeared clean throughout the facility. Storage containers with solid waste have tight-fitting covers. Program provides morning snack. Menus were posted and drinking water was readily available to children both indoors and outdoors. LPAs observed full legal signatures while reviewing the sign-in and sign-out sheets.

Two staff and four children's records were reviewed. Each child's file contained an emergency card and a medical assessment. At least one staff member present today has current Pediatric CPR and First Aid certification (exp. 12/15/19).

Report continues on 809-C.

SUPERVISOR'S NAME: Maria MayorgaTELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Amy SilvaTELEPHONE: (916) 926-9100
LICENSING EVALUATOR SIGNATURE:

DATE: 10/03/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2019
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: JAMES A. MCKEE ELEMENTARY SCHOOL
FACILITY NUMBER: 343616384
VISIT DATE: 10/03/2019
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All staff currently employed with the facility have a criminal record clearance through the school district. All staff present during today's inspection have Mandated Reporter training certificates and documentation of the educational background, training, and/or experience. LPAs reminded Site Supervisor that 100% supervision is required at all times, including in the bathroom. There are no firearms or bodies of water on the premises. LPAs observed a functional carbon monoxide detector. LPAs reviewed the Department's inspection authority and discussed with Site Supervisor any changes that may occur regarding the director or an employee acting in the director's absence must be reported to department within 10 working days.

Incidental Medical Services (IMS) policy was discussed. IMS is not currently provided by the facility; however, a Plan of Operation is available in the facility's file. 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.

LPA provided and discussed Effects of Lead Exposure brochure and the new immunization card.

This facility evaluation report was reviewed and discussed with Site Supervisor. A Notice of Site Visit was provided and should remain posted for a period of 30 days for parental review. Site Supervisor was encouraged to the visit the departments website at WWW.CDSS.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: Maria MayorgaTELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Amy SilvaTELEPHONE: (916) 926-9100
LICENSING EVALUATOR SIGNATURE:

DATE: 10/03/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2019
LIC809 (FAS) - (06/04)
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