343617467-4-22-2022-03-CC-ATIY-CDQTQY-20220422145644

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343617467
Report Date: 04/22/2022
Date Signed: 04/22/2022 02:56:51 PM

Document Has Been Signed on 04/22/2022 02:56 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:	PENLEIGH CHILD DEVELOPMENT CENTER		FACILITY NUMBER:	343617467
ADMINISTRATOR:	CAMASURA, MARIVEL		FACILITY TYPE:	850
ADDRESS:	1400 E STREET SUITE D & E		TELEPHONE:	(916) 822-5020
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95814
CAPACITY:	29	CENSUS: 14	DATE:	04/22/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:15 PM
MET WITH:	Marivel Camasura		TIME COMPLETED:	03:30 PM

NARRATIVE

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On April 22, 2022, at approximately 12:15 PM, Licensing Program Analysts (LPAs) Alize Tillery and Amanda Sutter met with Director Marivel Camasura for the purpose of an unannounced required 1 year annual inspection. Upon arrival, LPA observed 14 preschool children, supervised by 3 staff. The facility hours of operation are Monday through Friday from 7:00 AM to 5:30 PM. The facility does not offer transportation services.

LPAs toured all activity and classroom spaces (Butterflies room and Caterpillar room), kitchen, restrooms and outdoor play area. LPA discussed current COVID19 guidelines with Director. LPA observed the following documents are posted: License, Emergency Disaster Plan, Personal Rights, Parents' Rights Poster, and daily schedule. Cleaning disinfectants, medications and hazardous items are appropriately stored and inaccessible to children. Director stated there are no poisons or firearms on the premises. Furniture and equipment are in good condition, and toileting facilities are in safe, sanitary and operating condition, and the floors appeared to be clean throughout the facility. The program provides a morning and afternoon snack.

LPA observed trash bins with tight fitted lids. Drinking water is readily available to children both indoors and outdoors. Director stated that there is a water pitcher that is used and children’s personal cups. LPAs observed the facility’s sign in and out system. Facility has record of conducting fire drills at least every six months; last fire drill was conducted on 3/21/22. One of the playground equipment was observed to be damaged, with an attempt to repair with tape. There are sufficient equipment and toys, and there are shaded areas supplied by overhangs.

Report continues on 809-C.

SUPERVISOR'S NAME: Seychelle De Luca	TELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Alize Tillery	TELEPHONE: (916) 216-7798
LICENSING EVALUATOR SIGNATURE:	DATE: 04/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/22/2022

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 04/22/2022 02:56 PM - 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: PENLEIGH CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 343617467
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 04/22/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101238.2(d)(1)

Outdoor Activity Space

(d) The surface of the outdoor activity space shall be maintained: (1) In a safe condition for the activities planned. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, the licensee did not comply with the section cited above in that play equipment is damaged and wa attempted to be repaired with tape, which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 05/13/2022
	Plan of Correction
1 2 3 4	Director will submit a picture of the equipment either correctly repaired or removed from the play area.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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 Luca	TELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Alize Tillery	TELEPHONE: (916) 216-7798
LICENSING EVALUATOR SIGNATURE:	DATE: 04/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/22/2022

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: PENLEIGH CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 343617467
	VISIT DATE: 04/22/2022

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8 staff and 7 children's records were reviewed. Both children and staff files were observed to be complete. At least one staff member present today has a current Pediatric CPR and First Aid certification that expires in 12/2022. LPA reminded Director to keep a current Children’s Roster on file, that is to be maintained for three years. LPA reminded Licensees that 100% supervision is required at all times. LPAs observed a functional carbon monoxide detector, smoke detector and fire extinguisher. LPA reviewed the Department's inspection authority and discussed with designee any changes that may occur regarding the director or an employee acting in the director's absence must be reported to department within ten working days.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

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 is 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

Director was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

A deficiency is cited on the following 809D page. A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Director, Marivel Camasura.

SUPERVISOR'S NAME: Seychelle De Luca	TELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Alize Tillery	TELEPHONE: (916) 216-7798
LICENSING EVALUATOR SIGNATURE:	DATE: 04/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/22/2022

LIC809 (FAS) - (06/04)

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