343622021-11-4-2021-03-CC-JHOA-C8FR8K-20211104124805

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343622021
Report Date: 11/04/2021
Date Signed: 11/04/2021 12:48:12 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:	NATOMAS SCHOOL READINESS-WITTER RANCH		FACILITY NUMBER:	343622021
ADMINISTRATOR:	CLAUSSEN, LISA		FACILITY TYPE:	850
ADDRESS:	3790 POPPY HILL WAY		TELEPHONE:	(916) 567-5516
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95834
CAPACITY:	24	CENSUS: 22	DATE:	11/04/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:15 AM
MET WITH:	Inelva Carvajal and Tiffany Davidson		TIME COMPLETED:	01:05 PM

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, 11/04/21, Licensing Program Analysts (LPAs) Jan Hoshida and Josiah Gathing conducted an unannounced annual random inspection for the preschool program. LPA met with Office Specialist Inelva Carvajal and Coordinator Tiffany Davidson. Upon arrival, LPAs observed 22 children supervised by three staff members. This facility is located on Witter Ranch Elementary school. The facility operates Monday through Friday with two half day programs from 8:00am – 11:00am and 12:00pm – 3:00pm. The facility provides snacks and a take home lunch. LPAs conducted a health and safety inspection inside and outside of the facility. The following areas are in compliance during the visit. Firearms and ammunition are not on the premises. Staff acknowledged that storage area for poisons needs to be locked and stated that there are no poisons on site. Disinfectants, hazardous items and medications are inaccessible to children. Furniture and equipment are sufficient, age appropriate, and in good repair. Fire drills are conducted and documented. Carbon Monoxide detector was present. The playground equipment and outdoor activity space is maintained and in good condition. Foam ground cover is being used as cushioning around the climbing equipment and level is sufficient to absorb a fall. Children's toilets, hand washing facilities are sanitary. Floors are clean and free of debris. Drinking water is available both indoors and outside. Menus are posted. The facility is in compliance with conditions and limitations specified on the license. Sign in/sign out sheets are maintained. First Aid/CPR reviewed and in compliance. Emergency information reviewed for some children. Some staff records were reviewed. Staff stated that the facility has a new Administrator and they will submit the necessary paperwork to Community Care Licensing. *REPORT CONTINUED ON NEXT PAGE*

SUPERVISOR'S NAME: Seychelle De Luca	TELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Jan Hoshida	TELEPHONE: (916) 917-6572
LICENSING EVALUATOR SIGNATURE:	DATE: 11/04/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2021

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: NATOMAS SCHOOL READINESS-WITTER RANCH	FACILITY NUMBER: 343622021
	VISIT DATE: 11/04/2021

NARRATIVE

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Incidental Medical Services (IMS) policy was discussed. 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.

LPAs discussed current COVID guidelines with Staff. LPAs observed that staff and children were wearing masks.

Facility representative 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.

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.

No Title 22 Deficiencies observed in the areas that were evaluated. LPA reviewed report with the Director and provided copies. Exit interview conducted and report was reviewed with the facility representative Inelva Carvajal and Tiffany Davidson. A notice of site visit was given and must remain posted for 30 days.

SUPERVISOR'S NAME: Seychelle De Luca	TELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Jan Hoshida	TELEPHONE: (916) 917-6572
LICENSING EVALUATOR SIGNATURE:	DATE: 11/04/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2021

LIC809 (FAS) - (06/04)

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