343619766-3-18-2022-03-CC-KFEA-CCMQ2M-20220318114721

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343619766
Report Date: 03/18/2022
Date Signed: 03/18/2022 11:47:30 AM

Document Has Been Signed on 03/18/2022 11:47 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:	FOLSOM EDUCATIONAL ACADEMY		FACILITY NUMBER:	343619766
ADMINISTRATOR:	ELSAWAF, FATMA		FACILITY TYPE:	850
ADDRESS:	381 SOUTH LEXINGTON DR, #100		TELEPHONE:	(916) 790-8599
CITY:	FOLSOM	STATE: CA	ZIP CODE:	95630
CAPACITY:	27	CENSUS: 23	DATE:	03/18/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Fatma Elsawaf		TIME COMPLETED:	12:15 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	Licensing Program Analysts (LPAs) Kelly Ferrara and Amanda Sutter met with Facility Representative Fatma Elsawaf for an unannounced annual inspection on Friday, March 18th, 2022. At 9:30 AM, LPAs toured the facility including all activity and classroom spaces, restrooms, and outdoor play area. Census included 23 children in care with three staff. Facility Representative was reminded never to exceed the conditions, limitations and capacity specified on the license. Facility hours of operation are Monday to Friday 8:30 AM to 5:30 PM. Facility Representative 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. The classrooms appeared clean including the carpets and floor. Chemicals and cleaning materials were kept inaccessible to children. Playground equipment and surfaces were inspected and are in good condition with enough resilient material under climbing structures to absorb a fall. Uncontaminated drinking water was readily available to children both indoors and outdoors. Bathrooms were clean and all sinks and toilets were in operating condition. There are no firearms or bodies of water on the premises and the facility has at least one functioning smoke and carbon monoxide detector. Children bring their own lunches and snack and the facility has extra snacks available. LPAs observed parents are signing the children in and out of the facility. At 10:30 AM, staff files were reviewed. LPAs observed that four out of four staff files reviewed did not have a current Mandated Reporter certificate. LPAs reviewed staff transcripts and observed all staff being utilized as teachers were qualified. LPAs observed proof of immunizations for the staff. At least one staff had a current Pediatric CPR and First Aid certification that expires November 2023. LPAs observed the sample of children’s files contained the appropriate documents. LPA observed a current children's roster and a fire/disaster drill log. The facility is equipped with First Aid equipment.

SUPERVISOR'S NAME: Maria Mayorga	TELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Kelly Ferrara	TELEPHONE: (916) 425-5932
LICENSING EVALUATOR SIGNATURE:	DATE: 03/18/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/18/2022

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: FOLSOM EDUCATIONAL ACADEMY	FACILITY NUMBER: 343619766
	VISIT DATE: 03/18/2022

NARRATIVE

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This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.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

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/inspection-process.

Facility Representative was encouraged to the visit the Department's website at WWW.CCLD.CA.GOV for information regarding child care updates, PINs, forms, regulations and legislation pertaining to child care centers.

One Type B citation was issued based on today's inspection. Exit interview was conducted and report was reviewed with the Facility Representative. A notice of site visit was given and must remain posted for 30 days.

SUPERVISOR'S NAME: Maria Mayorga	TELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Kelly Ferrara	TELEPHONE: (916) 425-5932
LICENSING EVALUATOR SIGNATURE:	DATE: 03/18/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/18/2022

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 03/18/2022 11:47 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: FOLSOM EDUCATIONAL ACADEMY	FACILITY NUMBER: 343619766
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/18/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on facility file review, the licensee did not comply with the section cited above in four out of four staff files which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 04/01/2022
	Plan of Correction
1 2 3 4	Facility representative shall submit a Mandated Reporter certificate to LPA for each staff by POC due date above. Training can be found online at Mandatedreporterca.com.

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: Maria Mayorga	TELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Kelly Ferrara	TELEPHONE: (916) 425-5932
LICENSING EVALUATOR SIGNATURE:	DATE: 03/18/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/18/2022

LIC809 (FAS) - (06/04)

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