343619995-11-5-2021-03-CC-MLOR-C8GPP4-20211105112854

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343619995
Report Date: 11/05/2021
Date Signed: 11/05/2021 11:29:03 AM

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:	RIO LINDA PRESCHOOL CENTER		FACILITY NUMBER:	343619995
ADMINISTRATOR:	YANG, MAY		FACILITY TYPE:	850
ADDRESS:	631 L STREET		TELEPHONE:	(916) 566-1600
CITY:	RIO LINDA	STATE: CA	ZIP CODE:	95673
CAPACITY:	48	CENSUS: 5	DATE:	11/05/2021
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Tabitha Thompson		TIME COMPLETED:	11:40 AM

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	Application Specialist (AS) Mai Lor and Licensing Program Analyst (LPA) Fabiola Diaz met with Licensee Tabitha Thompson for the purpose of an announced capacity change case management inspection. Licensee request to decrease the preschool capacity from 48 to 24 preschool children ages three to entry into Kindergarten. The operates in classroom #20. Census included 5 preschool children supervised by 3 staff. The facility's hours of operation are Monday through Friday from 8:00 AM to 2:30 PM. AS Lor received the fire clearance on 8/26/21. AS and LPA conducted a health and safety inspection in all areas accessible to preschool children. AS and LPA measured classroom #20. The total classroom space contains a total of 945.7724 square feet, which will accommodate the requested capacity of 24 preschool children. There are four toilets and five sinks available to children, and a separate staff restroom is available. Individual measurements are recorded on the Capacity Worksheet (LIC 9024). Children who become ill during the day will be isolated in a designated place in the classroom and will use staff restroom, if necessary. AS and LPA observed sufficient number of furniture, toys, mats, cubbies, and play equipment in the classrooms. AS and LPA did not observed a carbon monoxide detector. AS and LPA observed disinfectants and medications are inaccessible and appropriately stored. AS and LPA observed an electronic sign-in/sign-out system. Licensee stated the facility will provide breakfast, lunch and PM snacks. There is one outdoor area on the property designated for preschool, infant, and toddler children. The outdoor play area is fenced with a chain link fence that is four feet tall. AS and LPA observed a variety of age-appropriate outdoor toys and equipment. There is a play structure that is designated for children ages 2 to 5. There is a second play structure without a safety label. Applicant was reminded to follow the safety label and staff will provide supervision to ensure children under the age of 2 will not be using the play structure. (Report continues on subsequent LIC809)

SUPERVISOR'S NAME: Roxana Saravia	TELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Mai Lor	TELEPHONE: (916) 491-0182
LICENSING EVALUATOR SIGNATURE:	DATE: 11/05/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/05/2021

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: RIO LINDA PRESCHOOL CENTER	FACILITY NUMBER: 343619995
	VISIT DATE: 11/05/2021

NARRATIVE

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Applicant submitted a waiver request to share the outdoor space between the preschool, infant, and toddler children. Applicant shall follow the rotated schedule previously submitted. AS and LPA observed woodchips used as cushion. Applicant was reminded to replace woodchips as they get depleted. The playground is shaded by trees and overhangs.

AS and LPA measured the outdoor space. The outdoor preschool yard contains a total of 7034.514 square feet, which will accommodate Licensee's request for 24 preschool children. Individual measurements are recorded on the Capacity Worksheet (LIC 9024).

Prior to this inspection, AS emailed LIC311A, Effects of Lead Exposure brochure and Provider Notice Information (PIN) 21-21 (Release of the Written Directives for Lead Testing of Water in Licensed Child Care Centers per AB 2370), and immunization card. AS and LPA reviewed lead testing requirement and COVID-19 technical assistance with the Licensee

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

Licensee 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.

Licensee was encouraged to visit the Department website at WWW.CCLD.CA.GOV for child care updates, current forms, legislation and regulation information. A copy of this report will remain on file for a period of three years for public review upon request.

(Report continues on subsequent LIC809)

SUPERVISOR'S NAME: Roxana Saravia	TELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Mai Lor	TELEPHONE: (916) 491-0182
LICENSING EVALUATOR SIGNATURE:	DATE: 11/05/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/05/2021

LIC809 (FAS) - (06/04)

Page: 2 of 3

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: RIO LINDA PRESCHOOL CENTER	FACILITY NUMBER: 343619995
	VISIT DATE: 11/05/2021

NARRATIVE

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Prior to licensure, the following items must be corrected:

1.. Revised emergency disaster plan to include a second temporary relocation site
2. Updated job description
3. Carbon monoxide detector
4. Licensing Program Manager's final review

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

Exit interview conducted and report was reviewed with the licensee, Tabitha Thompson.

SUPERVISOR'S NAME: Roxana Saravia	TELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Mai Lor	TELEPHONE: (916) 491-0182
LICENSING EVALUATOR SIGNATURE:	DATE: 11/05/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/05/2021

LIC809 (FAS) - (06/04)

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