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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343621353
Report Date: 11/04/2019
Date Signed: 11/04/2019 09:51:13 AM

COMPREHENSIVE INSPECTION
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:NATOMAS SCHOOL READINESS, NATOMAS PARK ELEMENTARYFACILITY NUMBER:
343621353
ADMINISTRATOR:SMITH, CHRISTINEFACILITY TYPE:
850
ADDRESS:4700 CREST DRIVETELEPHONE:
(916) 567-5516
CITY:SACRAMENTOSTATE: CAZIP CODE:
95835
CAPACITY:24CENSUS: 22DATE:
11/04/2019
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Shelly Potter & Tiffany DavidsonTIME COMPLETED:
10:00 AM
NARRATIVE
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Licensing Program Analyst (LPA) Seychelle De Luca met with Site Supervisor Shelly Potter for the purpose of an unannounced annual random inspection. During the course of the visit, Licensee Representative Tiffany Davidson arrived. Licensee Representative was reminded never to exceed the conditions, limitations, and capacity specified on the license. Upon arrival, LPA observed 22 preschool children supervised by Site Supervisor and two staff. All criminal record clearances are obtained through the school district. Facility hours of operation are Monday through Friday from 8:00am to 11:00am and 12:00pm to 3:00pm, and the facility follows the school calendar.

LPA toured all activity and classroom space, restrooms, and outdoor play areas. Medications are appropriately stored and inaccessible to children. Licensee Representative stated there are no poisons on the premises. Toxic and hazardous items are inaccessible to children. Furniture and equipment are in good condition. Playground equipment and surfaces are free of loose or sharp parts. The areas around or under climbing equipment are cushioned with pour in rubber to absorb the fall. Toileting facilities are in sanitary and operating condition. The floors appeared clean throughout the facility. All food was protected against contamination. Trash cans containing solid waste have lids. Facility program provides breakfast and supper. Licensee Representative stated that food is prepared in the school cafeteria. Menus were posted and drinking water was readily available to children both indoors and outdoors. LPA reminded Licensee Representative that 100% supervision is required at all times, including in the bathroom. There are no firearms or bodies of water on the premises. LPA observed a functional carbon monoxide detector that is hardwired into the fire alarm system.

Report continued on 809-C.

SUPERVISOR'S NAME: Roxana SaraviaTELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Seychelle De LucaTELEPHONE: (916) 217-4316
LICENSING EVALUATOR SIGNATURE:

DATE: 11/04/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2019
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 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: NATOMAS SCHOOL READINESS, NATOMAS PARK ELEMENTARY
FACILITY NUMBER: 343621353
VISIT DATE: 11/04/2019
NARRATIVE
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Three staff and four children's records were reviewed. Each child's file contained an emergency card and a medical assessment. At least one staff member present today has current Pediatric CPR and First Aid certification (exp. 7/2020). All staff currently employed with the facility have documentation of the educational background, training, and/or experience. LPA reviewed the Department's inspection authority and discussed with Licensee Representative any changes that may occur regarding the director or an employee acting in the director's absence must be reported to department within 10 working days.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes 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 provided Lead Testing brochure and new immunization card. This facility evaluation report was reviewed and discussed with Licensee Representative. Licensee Representative was encouraged to the visit the Department's website at WWW.CCLD.CA.GOV for information regarding child care updates, forms, regulations and legislation pertaining child care centers. An exit interview was conducted.

Deficiencies are cited on the subsequent page of this report under the California Code of Regulations, Title 22. Licensee Representative was provided a copy of the Appeal Rights (LIC9058) and Licensee Representative's signature on this form acknowledges receipt of these rights.

SUPERVISOR'S NAME: Roxana SaraviaTELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Seychelle De LucaTELEPHONE: (916) 217-4316
LICENSING EVALUATOR SIGNATURE:

DATE: 11/04/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2019
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: NATOMAS SCHOOL READINESS, NATOMAS PARK ELEMENTARY
FACILITY NUMBER: 343621353
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/04/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/15/2019
Section Cited

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Reporting Requirements - The licensee shall notify the Department in writing of his/her intent prior to making any structural changes that reduce the total amount of indoor or outdoor activity space. Such structural changes shall include, but not be limited to, room additions. This requirement is not met as evidenced by LPA learning the program
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moved from room 125 to room 503 without notifying Community Care Licensing. This poses a potential health and safety concern.
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Type B
12/02/2019
Section Cited

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On or before March 30, 2018, a person who, on January 1, 2018, a licensed child 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
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following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by LPA learning staff have not completed the training. This poses a potential health and safety concern.
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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: Roxana SaraviaTELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Seychelle De LucaTELEPHONE: (916) 217-4316
LICENSING EVALUATOR SIGNATURE:
DATE: 11/04/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/04/2019
LIC809 (FAS) - (06/04)
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