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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343617412
Report Date: 09/01/2022
Date Signed: 09/01/2022 11:55:39 AM


Document Has Been Signed on 09/01/2022 11:55 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:CARING CONNECTION CHILDREN'S CENTERFACILITY NUMBER:
343617412
ADMINISTRATOR:JULIE JENKINSFACILITY TYPE:
850
ADDRESS:2100 J STREETTELEPHONE:
(916) 261-0796
CITY:SACRAMENTOSTATE: CAZIP CODE:
95816
CAPACITY:52CENSUS: 16DATE:
09/01/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Vanessa HalliwellTIME COMPLETED:
12:15 PM
NARRATIVE
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On September 1, 2022, at 8:30am, Licensing Program Analyst (LPA) Alize Tillery arrived to the facility to conduct a case management inspection. Upon arrival, LPA observed 16 children, supervised by 2 staff members, in the outdoor play area. Assistant Director, Vanessa Halliwell, arrived moments after LPA, and assisted LPA throughout the visit.

During today's inspection, LPA observed personnel files for five staff members. All staff files were observed to be incomplete. LPA reviewed and provided the LIC 125 Entrance Checklist to Assistant Director. Assistant Director understands what is to be maintained in each staff members file. Assistant Director stated that she is working with staff members on completing the files.

Based on observations, interview and record review, a deficiency is being cited for incomplete personnel files. See following 809D page for deficiency.

An exit interview was conducted with Assistant Director, Vanessa Halliwell. Appeal Rights were provided. A notice of site visit was issued and must remain posted for 30 days.
SUPERVISOR'S NAME: Seychelle De LucaTELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Alize TilleryTELEPHONE: (916) 216-7798
LICENSING EVALUATOR SIGNATURE:
DATE: 09/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/01/2022
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 09/01/2022 11:55 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: CARING CONNECTION CHILDREN'S CENTER
FACILITY NUMBER: 343617412

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/01/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/16/2022
Section Cited

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(a) Personnel records shall be maintained on the licensee, administrator, and each employee, and shall contain specified information.

Based on observation and record review, this requirement was not met evidenced by:
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LPA reviewed 5 staff personnel files and all files were observed to be complete.
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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: Alize TilleryTELEPHONE: (916) 216-7798
LICENSING EVALUATOR SIGNATURE:
DATE: 09/01/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/01/2022
LIC809 (FAS) - (06/04)
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