343619958-12-7-2022-03-CC-ABLI-CLW385-20221207170058

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343619958
Report Date: 12/07/2022
Date Signed: 12/07/2022 05:01:29 PM

Document Has Been Signed on 12/07/2022 05:01 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:	PACIFIC CHILDREN'S CENTER		FACILITY NUMBER:	343619958
ADMINISTRATOR:	ALYSSA HALL		FACILITY TYPE:	830
ADDRESS:	6560 MELROSE DRIVE		TELEPHONE:	(916) 566-1600
CITY:	NORTH HIGHLANDS	STATE: CA	ZIP CODE:	95660
CAPACITY:	25	CENSUS: 9	DATE:	12/07/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	04:00 PM
MET WITH:	Alyssa Hall		TIME COMPLETED:	05:15 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	An unannounced annual inspection is made today by Licensing Program Analyst Amanda Blesi. LPA met with lead teacher Sonia Garcia until Ms. Alyssa Hall arrived out of a staff meeting. ECE Tosa Christine Bellucci arrived with staff files to assist with today's inspection. Upon arrival LPA observed 4 babies under 12 months and 4 toddlers in the toddler option. Hours of operation are Monday through Friday, 7:00 AM – 5:00 PM. The following areas are in compliance during inspection: There are no bodies of water. Firearms and ammunition are not on the premises. Furniture and equipment are sufficient, age appropriate and in good repair. Bathrooms were clean and toilets and sinks were in working condition. Floors were clean. Carbon Monoxide detector is on the premises in combination with sprinklers and smoke. Storage containers for solid waste are covered. The facility is in compliance with conditions and limitations specified on the license. A fire drill was last conducted on 11/15/2022. Teacher/child ratios are maintained, and adequate supervision is being provided during this inspection. There is adequate space for children belongings. Napping equipment are in good repair. Sign in/sign out sheets maintained. All waivers are being followed. Criminal record clearances and/or exemptions are monitored by Department of Education. 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. First Aid/CPR reviewed and in compliance. Emergency information reviewed for some children. Staff records reviewed contain documentation of the educational background, training, and/or experience. LPA reviewed observed mandated reporter training in staff files. Report is continued on next page…LIC 809-C

SUPERVISOR'S NAME: Keven Peters	TELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Amanda Blesi	TELEPHONE: (916) 208-3427
LICENSING EVALUATOR SIGNATURE:	DATE: 12/07/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/07/2022

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: PACIFIC CHILDREN'S CENTER	FACILITY NUMBER: 343619958
	VISIT DATE: 12/07/2022

NARRATIVE

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LPA discussed Assembly Bill 2370, which will require licensed Child Care facilities to test their water for excessive amounts of lead. Testing will be required beginning January 1st, 2020 to January 1st, 2023 and must be conducted every five years from initial testing.

LPA provided the Community Care Licensing website www.ccld.ca.gov, so the licensee can obtain updated licensing information, new regulations and access forms. LPA advised licensee of their responsibility to stay current in regards to new regulations. LPA also included the email address for the children's advocacy program to stay current on new laws childcareadvocatesprogram@dss.ca.gov.

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 Family Child Care Homes Section 102417. 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

One Type B deficiency was cited today.

A notice of site visit was given and must remain posted for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100. Exit interview conducted and report was reviewed with the facility representative Alyssa Hall.

SUPERVISOR'S NAME: Keven Peters	TELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Amanda Blesi	TELEPHONE: (916) 208-3427
LICENSING EVALUATOR SIGNATURE:	DATE: 12/07/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/07/2022

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 12/07/2022 05:01 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: PACIFIC CHILDREN'S CENTER	FACILITY NUMBER: 343619958
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 12/07/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101221(b)(8)

Child's Records

(b) Each record shall contain information including, but not limited to, the following: (8) Medical assessment, including ambulatory status as specified in Section 101220, and the following health information: This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on a record review the licensee did not comply with the section cited above in 1 out of 4 files reviewed did not contain a phsycians medical assessment which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 01/07/2023
	Plan of Correction
1 2 3 4	To correct the deficiency, director shall obtain a completed medical assessment for Child #1 and submit a copy to LPA Blesi at amanda.blesi@dss.ca.gov. This shall be corrected by the plan of correction date of 1/7/23.

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: Keven Peters	TELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Amanda Blesi	TELEPHONE: (916) 208-3427
LICENSING EVALUATOR SIGNATURE:	DATE: 12/07/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/07/2022

LIC809 (FAS) - (06/04)

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