343623185-7-13-2022-03-CC-CBEO-CGASA3-20220713134140

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343623185
Report Date: 07/13/2022
Date Signed: 07/13/2022 01:41:49 PM

Document Has Been Signed on 07/13/2022 01:41 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:	SETA CP HUNTINGTON HEAD START		FACILITY NUMBER:	343623185
ADMINISTRATOR:	BELL, SABRINA		FACILITY TYPE:	850
ADDRESS:	5917 26TH STREET		TELEPHONE:	(916) 263-3800
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95822
CAPACITY:	28	CENSUS: 24	DATE:	07/13/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:30 AM
MET WITH:	Shannon Matlock		TIME COMPLETED:	02:00 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	Licensing Program Analyst (LPA) Christopher Bello arrived at the facility at approximately 11:30am to conduct an unannounced random annual inspection and a Case Management Capacity Increase today. LPA met with Shannon Matlock, director. A tour of the facility was conducted inside and outside. The following areas comply during the inspection. There are no bodies of water. Firearms and ammunition are not on the premises. Storage for poisons are locked. Disinfectants, hazardous items and medications are inaccessible to children. Furniture and equipment are enough, age appropriate and in good repair. Fire drills are conducted and documented. Carbon Monoxide detectors were present. The playground equipment and outdoor activity space is maintained and in good condition. Wood chips are being used as cushioning around the climbing equipment and level is enough to absorb a fall. Children's toilets, hand washing facilities are sanitary. Floors are clean and free of debris. Food is prepared offsite and delivered to the facility. Drinking water is available both indoors and outside. Menus are posted. The facility follows conditions and limitations specified on the license. Sign in/sign out sheets are maintained. No excluded individuals are present. 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. Some staff records were reviewed. The site has a shared play yard waiver. 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. LPA provided the Community Care Licensing’s website www.ccld.ca.gov, so the licensee can obtain updated licensing information, new regulations and access forms. LPA advised licensee of their responsibility to stay current in regards to new regulations. REPORT CONTINUES ON NEXT PAGE.

SUPERVISOR'S NAME: Roxana Saravia	TELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Christopher Bello	TELEPHONE: (916) 862-0844
LICENSING EVALUATOR SIGNATURE:	DATE: 07/13/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2022

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: SETA CP HUNTINGTON HEAD START	FACILITY NUMBER: 343623185
	VISIT DATE: 07/13/2022

NARRATIVE

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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 safe sleep regulations with Director and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed Director of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

LPA advised licensee to sign up for the quarterly updates provided by the Childcare Advocates Program. LPA provided the link https://www.cdss.ca.gov/inforesources/Community-Care-Licensing/subscribe for the licensee to sign up for the updates.

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.

Today’s Case Management Licensee Initiated Capacity Increase inspection regarded adding eight more toddlers for a total of 16 toddlers to the Toddler Option to the Preschool License. The applicant is requesting a license to serve 20 preschool children and a toddler option component of 16 toddlers for a total of 36 children.

REPORT CONTINUES ON NEXT PAGE.

SUPERVISOR'S NAME: Roxana Saravia	TELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Christopher Bello	TELEPHONE: (916) 862-0844
LICENSING EVALUATOR SIGNATURE:	DATE: 07/13/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2022

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: SETA CP HUNTINGTON HEAD START	FACILITY NUMBER: 343623185
	VISIT DATE: 07/13/2022

NARRATIVE

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INDOOR ACTIVITY SPACE:
Toddler Room Indoor Activity Space = 690 square feet, divided by 35 square feet, and sufficient indoor activity space to support the requested 16 toddlers.

Effective today 7/13/22, approved for 20 preschool children and a toddler option of 16 toddlers.

No Title 22 Deficiencies observed in the areas that were evaluated. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Director.

SUPERVISOR'S NAME: Roxana Saravia	TELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Christopher Bello	TELEPHONE: (916) 862-0844
LICENSING EVALUATOR SIGNATURE:	DATE: 07/13/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2022

LIC809 (FAS) - (06/04)

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