343616385-8-29-2022-03-CC-GSIH-CHRRRD-20220829131459

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343616385
Report Date: 08/29/2022
Date Signed: 08/29/2022 01:15:08 PM

Document Has Been Signed on 08/29/2022 01:15 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:	UNION HOUSE ELEMENTARY SCHOOL		FACILITY NUMBER:	343616385
ADMINISTRATOR:	MEYERSON, LINDA		FACILITY TYPE:	850
ADDRESS:	7850 DEER CREEK DRIVE		TELEPHONE:	(916) 424-9201
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95823
CAPACITY:	24	CENSUS: 7	DATE:	08/29/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:40 AM
MET WITH:	Robin Dyle		TIME COMPLETED:	01:30 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) Gagandeep Singh met with facility representative, Robin Doyle, for an annual inspection. Purpose of the inspection was explained. Present, there are seven children with two staff. Facility is operating with in the capacity and in compliance with staff child ratio on this day. During inspection, LPA inspected the day care classroom and the play yard. The facility operates at the school site in room D1. Facility has smoke detector, fully charged fire extinguisher and working telephone at the site. All of the cleaning solutions, poisons and other chemicals that are dangerous to the children are stored inaccessible to the children. Facility has age appropriate furniture. Furniture is steady and in good repair. All toilets, hand washing facilities are in working condition with proper sanitation in place. All storage containers for solid waste and in good repair and have proper tight - fitted lid on top. Facility has drinking water available for children. All the food is stored in properly manner and has lid to avoid any contamination. Play yard is free of hazards. All of the play structures are steady, in good repair and free of any loose parts. There is sufficient amount of wood chips under the play structures to prevent any fall injuries. There are benches with umbrella and trees to provide shade to the children in the play yard. There is water fountain with drinking water. LPA reviewed the facility records. Facility has all of the required documents posted and visible for public. LPA reviewed children's and all staff's records. LPA observed facility has record of names, addresses and telephone numbers of each child's authorized representative. One of the present staff members has record of valid CPR card in file. LPA reminded the facility representative that all staff is required to complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com. LPA observed the present staff has completion certificate on file. See next page for continuation .........

SUPERVISOR'S NAME: Natalie Dunaway	TELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Gagandeep Singh	TELEPHONE: (916) 216-7823
LICENSING EVALUATOR SIGNATURE:	DATE: 08/29/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2022

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: UNION HOUSE ELEMENTARY SCHOOL	FACILITY NUMBER: 343616385
	VISIT DATE: 08/29/2022

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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: http://www.ada.gov/childqanda.htm

LPA encourages the director to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates. Licensee can also email at childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list for the updates.

No deficiencies are cited today. The copy of this report is reviewed and provided to the facility representative. Notice of site visit is posted and shall remain posted for next 30 days.

SUPERVISOR'S NAME: Natalie Dunaway	TELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Gagandeep Singh	TELEPHONE: (916) 216-7823
LICENSING EVALUATOR SIGNATURE:	DATE: 08/29/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2022

LIC809 (FAS) - (06/04)

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