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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343622006
Report Date: 10/19/2022
Date Signed: 10/19/2022 05:32:08 PM

Document Has Been Signed on 10/19/2022 05:32 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:APPLE A DAY PRESCHOOL & INFANT CTR (PS)FACILITY NUMBER:
343622006
ADMINISTRATOR:FARFAN, LILIYAFACILITY TYPE:
850
ADDRESS:5013 EL CAMINO AVETELEPHONE:
(916) 481-5400
CITY:CARMICHAELSTATE: CAZIP CODE:
95608
CAPACITY: 36TOTAL ENROLLED CHILDREN: 36CENSUS: 12DATE:
10/19/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Liliya FarfanTIME COMPLETED:
05:40 PM
NARRATIVE
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At 11:30 a.m. on Wednesday, October 19th, 2022, Licensing Program Analyst (LPA) Karyn Guerra met with Director, Liliya Farfan, for the purpose of an unannounced required 1 year required inspection. Operating hours of the facility are from 0:00 a.m.-0:00 p.m., Monday thru Friday. A census of 12 preschool children supervised by 2 staff was observed.

All individuals subject to criminal background review have obtained criminal record clearance. Director 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.

A health and safety inspection was conducted in the classrooms, restrooms, food service areas, and outdoor play areas. LPA observed the following documents are posted: License, Emergency Disaster Plan, Personal Rights, Parents' Rights Poster, menus, and daily schedule. Cleaning disinfectants and hazardous items are appropriately stored and inaccessible to children. Medications are stored, inaccessible to children. Director stated there are no poisons on the premises. Furniture and equipment are in good condition, however, chairs are in need of cleaning. Toileting facilities are in safe, sanitary, and operating condition. Bins for solid waste in the have tight fitting lids. Tile flooring appeared clean, however, stains and dirt were observed on the area rugs in the classroom. The facility provides morning and afternoon snack. The food preparation space is free of litter and all food was protected against contamination. Drinking water was readily available to children both indoors and outdoors via labeled bottles. Facility uses an online application for sign in and sign out. There are no firearms or bodies of water on the premises. LPA observed a functional carbon monoxide detector. Playground equipment and surfaces are free of loose or sharp parts. Wood chip cushioning is in need of refilling. Outdoor shade is provided by trees.

Report continues on 809-C.

Seychelle De Luca
Karyn Guerra
DATE: 10/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/19/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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Document Has Been Signed on 10/19/2022 05:32 PM - It Cannot Be Edited


Created By: Karyn Guerra On 10/19/2022 at 03:38 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: APPLE A DAY PRESCHOOL & INFANT CTR (PS)
FACILITY NUMBER: 343622006

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/19/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101238.3(b)
Indoor Activity Space
(b) The floors of all rooms shall have a surface that is safe and clean.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above as stains and dirt were observed on area rugs in the classroom, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/21/2022
Plan of Correction
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Director will provide work order or photo documentation of cleaned carpets by POC due date.
Type B
Section Cited
CCR
101239(n)
Fixtures, Furniture, Equipment and Supplies
(n) Furniture and equipment shall be maintained in good condition, free of sharp, loose or pointed parts.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above as chairs in the facility were in need of cleaning, and some soft cushioning equipment was worn, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/21/2022
Plan of Correction
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Director will provide photo documentation of cleaned chairs by POC due date.
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:Seychelle De Luca
LICENSING EVALUATOR NAME:Karyn Guerra
LICENSING EVALUATOR SIGNATURE:
DATE: 10/19/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/19/2022


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Document Has Been Signed on 10/19/2022 05:32 PM - It Cannot Be Edited


Created By: Karyn Guerra On 10/19/2022 at 03:38 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: APPLE A DAY PRESCHOOL & INFANT CTR (PS)
FACILITY NUMBER: 343622006

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/19/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101238.2(e)
Outdoor Activity Space
(e) As a condition of licensure, the areas around and under high climbing equipment, swings, slides and other similar equipment shall be cushioned with material that absorbs falls.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above as the wood chip cushioning was low and in need of refilling, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/01/2022
Plan of Correction
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Director will provide photo evidence of filled wood chip cushioning or will provide documentation of purchase/work order by POC due date.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Seychelle De Luca
LICENSING EVALUATOR NAME:Karyn Guerra
LICENSING EVALUATOR SIGNATURE:
DATE: 10/19/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/19/2022


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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: APPLE A DAY PRESCHOOL & INFANT CTR (PS)
FACILITY NUMBER: 343622006
VISIT DATE: 10/19/2022
NARRATIVE
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Staff files were reviewed. At least one staff member present today has current Pediatric CPR and First Aid certification. LPA observed immunization records and documentation of the educational background, training, and/or experience and AB 1207 Mandated Reporter training certificates.

Children's records were reviewed. Each child's file contained an emergency card, consent for emergency medical treatment and notifications of children’s and parent’s rights, health history, physician's report and immunization records.

This facility provides Incidental Medical Services – IMS. A plan of operation is on file at the facility. 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.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

Title 22 deficiencies are cited on the subsequent pages of this report. Appeal rights were provided. Exit interview conducted and report was reviewed with Director, Liliya Farfan. A notice of site visit was given and must remain posted for 30 days.

SUPERVISOR'S NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Karyn Guerra
LICENSING EVALUATOR SIGNATURE:

DATE: 10/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2022
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