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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343620028
Report Date: 10/11/2019
Date Signed: 10/11/2019 12:00:56 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:PLAY-OLOGYFACILITY NUMBER:
343620028
ADMINISTRATOR:VANCE, JENNIFERFACILITY TYPE:
830
ADDRESS:3084 SUNRISE BLVD STE 4TELEPHONE:
(916) 853-5678
CITY:RANCHO CORDOVASTATE: CAZIP CODE:
95742
CAPACITY:16CENSUS: 6DATE:
10/11/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
08:25 AM
MET WITH:Jennifer VanceTIME COMPLETED:
12:20 PM
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Licensing Program Analyst (LPA), Jan Hoshida, conducted an unannounced annual random inspection for the infant program. LPA met with Director, Jennifer Vance. Upon arrival, LPA observed six infants supervised by two staff members. A tour of the infant area was conducted inside and outside. The infant indoor activity space is physically separate from the space used by other day care children. The facility has a waiver on file to rotate the use of the outdoor play area with the preschool. Infant furniture and equipment, including cribs, cots/mats, and feeding chairs are sufficient, age appropriate and in good repair. Infant changing tables have padded surface no less than one inch thick, covered with washable vinyl or plastic, and have raised sides at least three inches high. Toys are safe, without sharp points, edges, splinters or small parts that can be pulled off and swallowed. All infants including are under visual observation at all times. Feeding plans and Needs and Services plans reviewed. The facility utilizes an electronic sign in and out system. Facility is in compliance with staff infant ratios. Staff utilized as infant teachers have three child development units in infant/toddler care. There are no bodies of water on the premises. Firearms and ammunition are not on the premises. Storage area for poisons is locked. Disinfectants, hazardous items and medications are inaccessible to children. Fire drills are conducted at least once every six months and documented. Rooms are safe and clean. The facility is in compliance with conditions and limitations specified on the license. All staff subject to a criminal record clearance or exemption are associated to the facility. 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 and, a Health Screening/TB test and immunization records to meet SB 792. Facility’s operating hours are Monday through Friday from 7:00 am to 6:00 pm.

REPORT CONTINUED ON NEXT PAGE
SUPERVISOR'S NAME: Bettina EngelmanTELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Jan HoshidaTELEPHONE: (916) 917-6572
LICENSING EVALUATOR SIGNATURE:

DATE: 10/11/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2019
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: PLAY-OLOGY
FACILITY NUMBER: 343620028
VISIT DATE: 10/11/2019
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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 Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. 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.

LPA discussed the new Mandated Reporter Training with Director. Beginning January 1, 2018, Health and Safety Code 1596.8662 requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Volunteers are encouraged but not required to take the training. In addition, existing staff must meet requirements by March 30, 2018. This training requirement may be met by using the Department’s Office of Child Abuse Prevention (OCAP) online training modules. The OCAP modules are free of cost and available at: http://www.mandatedreporterca.com/. The training is currently provided in English.

LPA checked facilities fees and confirmed that it is up to date.

LPA provided the Community Care Licensing’s website www.ccld.ca.gov, so the Director can obtain updated licensing information, new regulations and access forms. LPA advised Director 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.

No Title 22 Deficiencies observed in the areas that were evaluated. LPA reviewed report with the Director and provided copies. An exit interview was conducted. LPA observed the Notice of Site Visit posted and the Director understands it must remain posted for 30 days.
SUPERVISOR'S NAME: Bettina EngelmanTELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Jan HoshidaTELEPHONE: (916) 917-6572
LICENSING EVALUATOR SIGNATURE:

DATE: 10/11/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2019
LIC809 (FAS) - (06/04)
Page: 2 of 2