343616737-12-11-2020-03-CC-JHOA-BW7US9-20201211144956

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343616737
Report Date: 12/10/2020
Date Signed: 12/11/2020 02:50:06 PM

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:	CALVARY CHRISTIAN SCHOOL-AGE CARE		FACILITY NUMBER:	343616737
ADMINISTRATOR:	ARRIAGA, SUSAN		FACILITY TYPE:	840
ADDRESS:	4911 47TH AVENUE		TELEPHONE:	(916) 393-3633
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95824
CAPACITY:	20	CENSUS: 21	DATE:	12/10/2020
TYPE OF VISIT:	Case Management - Other	ANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Sue Arriaga		TIME COMPLETED:	02:15 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	On 12/10/20 at 1:00pm, Licensing Program Analyst (LPA), Jan Hoshida, conducted a case management visit via Zoom, due to the COVID-19 pandemic, with Sue Arriaga, Preschool/School Age Care Director & Superintendent of Schools. The purpose of this inspection was to provide technical assistance and ensure the facility is safe for the care and supervision of the children. Due to COVID-19 State of Emergency, a Licensed Child Care Program Waiver was granted on 9/21/20 to temporarily care for 36 additional school-age children in unlicensed private school classrooms of Calvary Christian School located at 4911 47th Avenue, Sacramento, CA 95824. With this waiver, the facility has been approved for the total temporary capacity is 56 school age children. A letter from the Calvary Christian School principal confirmed fire clearance for the facility. This program operates from Monday to Friday from 6:00am to 6:00pm. During the tele-inspection, there were 21 school age children with 4 staff. LPA virtually toured the facility with Director. The waiver was approved to operate in unlicensed private school classrooms (#4, #7 and #8). The licensed school-age program operates in room #1. LPA observed age-appropriate furniture including tables and chairs in the classrooms to meet the needs of children in care. The majority of the day is dedicated to the children's distance learning and each child has their own table to be able to do their schoolwork which is socially distanced from the other children and staff. Children are placed in pods up to 12 children with 1-2 staff members. There is a sufficient amount of separate private bathrooms that are reserved for the school-age children. In addition, LPA toured the existing shared outdoor playground area. LPA observed an area at the entrance designated for sign in/out, temperature/health checks and COVID-19 information. Public health documents/posters and the waiver were seen throughout the facility. The facility provides an afternoon snack, breakfast and lunch. Children bring their own water bottles which can be refilled within the center. *REPORT CONTINUED ON NEXT PAGE*

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Jan Hoshida	TELEPHONE: (916) 917-6572
LICENSING EVALUATOR SIGNATURE:	DATE: 12/10/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/10/2020

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: CALVARY CHRISTIAN SCHOOL-AGE CARE	FACILITY NUMBER: 343616737
	VISIT DATE: 12/10/2020

NARRATIVE

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Hand sanitizers are located throughout the facility which will still need to be inaccessible to children. LPA observed that there were school-age children within licensed preschool classroom #2. Director stated that the school-age children will be move to one of the approved unlicensed classrooms and school-age children will no longer use the preschool classroom.

Staff have their own separate bathroom. Staff conduct regular cleaning and sanitizing of the facility throughout the day. LPA reminded Director to store cleaning supplies and hazardous items of reach of children. Staff were observed wearing face masks. Cohort guidance was discussed. A first aid kit is on site and the office and the individual restroom will be used in case child feels ill.

Department of Public Health and Community Care Licensing will be contacted in regards any COVID-19 illness. The facility will follow the Childcare Guidance on group size, face coverings, social distancing, health screening, hand washing, cleaning and sanitation.

A Notice of Site Visit was provided and should remain posted for 30 days.

Facility evaluation report was emailed to Director and an email verification of receipt of report will be used in lieu of a signature on this report.

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Jan Hoshida	TELEPHONE: (916) 917-6572
LICENSING EVALUATOR SIGNATURE:	DATE: 12/10/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/10/2020

LIC809 (FAS) - (06/04)

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