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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343616543
Report Date: 09/15/2022
Date Signed: 09/15/2022 10:04:29 AM


Document Has Been Signed on 09/15/2022 10:04 AM - 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:SAN JUAN PRE-SCHOOLFACILITY NUMBER:
343616543
ADMINISTRATOR:LEWIS, JENNYFACILITY TYPE:
830
ADDRESS:7413 WISCONSIN DRIVETELEPHONE:
(916) 863-0337
CITY:CITRUS HEIGHTSSTATE: CAZIP CODE:
95610
CAPACITY:12CENSUS: 4DATE:
09/15/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
08:55 AM
MET WITH:Savannah ButlerTIME COMPLETED:
10:15 AM
NARRATIVE
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At 8:55 a.m. on Thursday, September 15th, 2022, Licensing Program Analysts (LPAs) Karyn Guerra and Matthew Gallo met with Staff, Savannah Butler, for the purpose of a case management inspection. At 9:00 a.m., LPAs observed a census of 4 infant children supervised by 1 staff (S1). Children were awake in the main classroom play space, and no other support staff were in the building. A follow up interview with S1 was conducted and it was revealed that S1 does not have any Early Childhood Education (ECE) nor infant units. This poses an immediate risk to the health and safety of children in care. At 9:33 a.m., a substitute staff from the sister facility arrived to support the infant classroom.

Title 22 deficiencies are cited on the subsequent pages of this report. Staff acknowledges, that FOR TYPE A DEFICIENCIES ONLY upon receipt, licensee shall post LIC 9099D with Type A deficiencies for 30 days and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. LIC 9224 must be signed by parents/guardians and kept with the children's forms as a receipt whenever any Type A documents are provided by the licensee. LIC 9224 and Appeal Rights were provided. Staff's signature on this report acknowledges receipt of these rights. This report was reviewed with the Staff, Savannah Butler. An exit interview was conducted. A Notice of Site Visit was provided and shall remain posted for a period of 30 days.
SUPERVISOR'S NAME: Seychelle De LucaTELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Karyn GuerraTELEPHONE: (916) 216-7790
LICENSING EVALUATOR SIGNATURE:
DATE: 09/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/15/2022
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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Document Has Been Signed on 09/15/2022 10:04 AM - It Cannot Be Edited

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: SAN JUAN PRE-SCHOOL
FACILITY NUMBER: 343616543

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/15/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/16/2022
Section Cited

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(b) Prior to employment, an infant care teacher shall have completed, with passing grades, at least three postsecondary semesters or equivalent quarter units in early childhood education or child development, and three postsecondary semester or equivalent quarter units related to the care of infants, at an accredited or approved college or university. This requirement was not met, as evidenced by:
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Based on interviews, S1 does not have any ECE nor infant units and was left alone with children. This poses an immediate risk to the health and safety of children in care.
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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 LucaTELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Karyn GuerraTELEPHONE: (916) 216-7790
LICENSING EVALUATOR SIGNATURE:
DATE: 09/15/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/15/2022
LIC809 (FAS) - (06/04)
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