<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343621414
Report Date: 02/24/2022
Date Signed: 02/24/2022 11:08:01 AM


Document Has Been Signed on 02/24/2022 11:08 AM - 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:TOTS OF LOVE - ELK GROVE WESTFACILITY NUMBER:
343621414
ADMINISTRATOR:WILLIAMS, COURTNEYFACILITY TYPE:
850
ADDRESS:3151 DWIGHT ROAD, SUITE 400TELEPHONE:
(916) 689-8687
CITY:ELK GROVESTATE: CAZIP CODE:
95758
CAPACITY:37CENSUS: 14DATE:
02/24/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
09:20 AM
MET WITH:Nicole MoranTIME COMPLETED:
11:25 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
On Thursday, February 24,2022 at 09:25 am, Licensing Program Analysts (LPAs) Elvira Sierra and Katy Maestas met with Site Supervisor, Nicole Moran for a case management inspection. The purpose of the inspection was explained and was to discuss an unusual incident that occurred on 01/18/22; which was self-reported to the Department by the facility on 01/20/22. Facility reported that, a bottle of hand sanitizer was in a toy cart located in a corner of the classroom. This resulted in a child placing a squirt of hand sanitizer in her mouth. During the inspection, LPA conducted an interview with the Director. Director stated staff immediately rinsed her mouth with water and contacted parents and poison control. The director stated she met with staff individually to discussed proper storage of hazardous items.

Title 22 deficiency has been cited on the subsequent page 809D. Director acknowledges that FOR TYPE A DEFICIENCIES ONLY upon receipt, licensee shall post LIC 809-D with Type A deficiency for 30 days and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. The LIC 9224 must be signed by parents/guardians and kept with the children's records as a receipt (LIC 9224 was provided).
SUPERVISOR'S NAME: Bettina EngelmanTELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Elvira SierraTELEPHONE: (916) 216-8826
LICENSING EVALUATOR SIGNATURE:
DATE: 02/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/24/2022
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


Document Has Been Signed on 02/24/2022 11:08 AM - 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: TOTS OF LOVE - ELK GROVE WEST
FACILITY NUMBER: 343621414

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/24/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/25/2022
Section Cited

1
2
3
4
5
6
7
Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to children shall be stored where inaccessible to children. This requirement was not met as evidenced by;

8
9
10
11
12
13
14
Based on disclosure made during self-reporting the center failed to ensure hazardous items were inaccessible to children in care. This poses an immediate health and safety risk to children in care.
8
9
10
11
12
13
14

1
2
3
4
5
6
7

1
2
3
4
5
6
7
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: Bettina EngelmanTELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Elvira SierraTELEPHONE: (916) 216-8826
LICENSING EVALUATOR SIGNATURE:
DATE: 02/24/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/24/2022
LIC809 (FAS) - (06/04)
Page: 2 of 2