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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343619958
Report Date: 11/18/2021
Date Signed: 11/19/2021 02:42:23 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:PACIFIC CHILDREN'S CENTERFACILITY NUMBER:
343619958
ADMINISTRATOR:ALYSSA HALLFACILITY TYPE:
830
ADDRESS:6560 MELROSE DRIVETELEPHONE:
(916) 566-1600
CITY:NORTH HIGHLANDSSTATE: CAZIP CODE:
95660
CAPACITY:25CENSUS: 9DATE:
11/18/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:40 AM
MET WITH:Alyssa Hall, Lena Soundrs, Nicole SchileTIME COMPLETED:
02:00 PM
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On 11/18/21 at 11:45AM, a annual/required inspection was made to the facility by Licensing Program Analyst (LPA) M. Martinez and T. Washington and met with Director Alyssa Hall. The facility file was reviewed prior to this inspection. A review of the personnel report indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. Facility staff are listed under the school districts clearance list. The facility’s operating hours are 7-5, Mon-Fri. The facility was toured at 12:00PM inside and outside and the floor and yard plan submitted by the licensee were verified. There are no pools or similar bodies of water. The Director stated no firearms or weapons are stored on site and none were observed. The items which could pose a danger to children are inaccessible to children. Poisons are locked within the janitorial office within the school and other cleaning solutions are kept away from children. Furniture and equipment are in good condition, free of hazards, and age appropriate. The outdoor activity space was cushioned with grass and free of hazards. Toilets and sinks are in sanitary condition and operating properly. The facility floors were clean and safe. The kitchen/food preparation area is clean, and free of litter or rodents. Food is properly stored and free of contamination. Trash cans have tight fitting lids. Drinking water is available to children both inside via water jug and outside the same manner. The facility was free of flies, insects and rodents. The facility has a working carbon monoxide detector. During today's inspection, staffing ratios were being met and there were 9 infants were being supervised by 8 teachers/aides. Infants are not left without visual supervision at any time. The facility was operating within the licensed capacity. At least one staff member present during the visit (S1) possessed current CPR and First Aid certifications. The sign in/out sheet was reviewed, and representatives are using full signatures and recording the time. Staff are provided on-the-job training, including sanitation and universal precautions. Infants with symptoms of illness are not accepted, and children who become ill during the day are isolated in kitchen area or up front where they can be separated from other children. A weekly menu was posted at the parents board.

(cont.)
SUPERVISOR'S NAME: Maria MayorgaTELEPHONE: (916) -26-1414
LICENSING EVALUATOR NAME: Mikah MartinezTELEPHONE: (916) 862-1086
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 2
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: PACIFIC CHILDREN'S CENTER
FACILITY NUMBER: 343619958
VISIT DATE: 11/18/2021
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The facility has a crib or mat/cot for each napping infant. Cribs are free of loose objects. Infants are visually supervised at all times while sleeping, and staff physically check on sleeping infants every 15 minutes. The 15 minute checks are currently not documented however LPA's discussed the protocol to physically document and remain in the infants file. Infants under 12 months are placed on their backs for sleep, and no infants are swaddled. Nine children’s records were reviewed at 12:35PM, and contained emergency identification forms, medical assessments, and Needs and Services Plans. Infants up to 12 months have an Infant Sleeping Plan on file. Six staff records were reviewed at 12:15PM, and contained proof of qualifications. All licensing reports are public information and must be made available upon request for at least three years.

Notice of Site Visit shall be posted for 30 days from today's visit.

There were no Title 22 deficiencies cited during today's inspection.
SUPERVISOR'S NAME: Maria MayorgaTELEPHONE: (916) -26-1414
LICENSING EVALUATOR NAME: Mikah MartinezTELEPHONE: (916) 862-1086
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2021
LIC809 (FAS) - (06/04)
Page: 2 of 2