343623930-6-8-2021-03-CC-MLOR-C3SR4D-20210608124122

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343623930
Report Date: 06/08/2021
Date Signed: 06/08/2021 12:41:32 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:	BUSY BEE CDC ON L STREET		FACILITY NUMBER:	343623930
ADMINISTRATOR:	DOMONDON, JUDITH		FACILITY TYPE:	830
ADDRESS:	2324 L STREET		TELEPHONE:	(916) 457-7348
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95816
CAPACITY:	32	CENSUS: 0	DATE:	06/08/2021
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Jude Domondon and Diana Yactayo		TIME COMPLETED:	12:45 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) Mai Lor and Licensing Program Manager (LPM) Seychelle De Luca met with Applicant Domondon and Assistant Director Diana Yactayo for the purpose of an announced pre-licensing inspection. Applicant requests an infant license to serve 12 infant children from birth to two years of age. The program will operate Monday through Friday from 7:00 AM to 6:00 PM. The fire clearance was granted; however, an updated fire clearance with the corrected capacity was sent out on 6/1/2021 and is currently pending fire inspector’s approval. Applicant acknowledges that the following documents must be posted at all times: License, Emergency Disaster Plan, Personal Rights, Parents' Rights Poster, Effects of Lead Exposure, car seat poster, menus, and daily schedule. LPA and LPM provided and discussed LIC311A and the forms that must be in each child's and each staff member's file. Applicant stated the Needs and Services plans will be kept in the classrooms. The facility will be providing breakfast, lunch, and snacks. Parents will provide formula, breast milk, and baby food for their children. INDOOR ACTIVITY SPACE: There are two infant classrooms (Room 105 and 106). Room 105 will be utilized as a napping room. The courtyard will also be used as infant space. Facility will need to purchase additional storage space and napping equipment for the infants to meet the requested capacity of 12 infants. Medications will be stored in each classroom. LPA and LPM observed cleaning disinfectants are appropriately stored and inaccessible to children. Applicant stated there are no poisons or firearms on the premises. Parents will be providing water. LPA and LPM observed a functional carbon monoxide detector in all classrooms. Medications will be stored in each of the classrooms. Facility will be using paper sign in and sign out. Report continues on 809-C.

SUPERVISOR'S NAME: Roxana Saravia	TELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Mai Lor	TELEPHONE: (916) 491-0182
LICENSING EVALUATOR SIGNATURE:	DATE: 06/08/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/08/2021

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: BUSY BEE CDC ON L STREET	FACILITY NUMBER: 343623930
	VISIT DATE: 06/08/2021

NARRATIVE

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LPA and LPM measured the classroom and courtyard . The total classroom and courtyard space contains a total of 568 square feet, which will accommodate Applicant's request for 12 infant children. There are eight toilets, two potty chairs, and nine sinks for the children, and a separate private restroom for the staff. LPA observed a changing table within arm's reach of a sink with a changing pad that is at least one inch thick with raised sides that are at least three inches tall. Individual measurements are recorded on the Capacity Worksheet (LIC 9024). Children who become ill during the day will be isolated in the office area and will use the staff restroom, if necessary.

OUTDOOR ACTIVITY SPACE:
There is one outdoor area on the property for infant. The outdoor play area is fenced with a wrought iron fence that is four feet tall. The yard is separated into two sections with a wood fence, designating one side for the preschool and one side to be shared with infant and toddler. A waiver is to be submitted for shared outdoor space. Facility is planning on putting in a play structure. There are no bodies of water on the premises. There are shaded areas supplied by trees and overhangs.

LPA and LPM measured the outdoor activity space. The outdoor play area contains a total of 3835 square feet, which will accommodate Applicant's request for 12infant children. Individual measurements are recorded on the Capacity Worksheet (LIC 9024).

The facility's Plan of Operation is located in the preschool file. 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.

Report continues on 809-C.

SUPERVISOR'S NAME: Roxana Saravia	TELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Mai Lor	TELEPHONE: (916) 491-0182
LICENSING EVALUATOR SIGNATURE:	DATE: 06/08/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/08/2021

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: BUSY BEE CDC ON L STREET	FACILITY NUMBER: 343623930
	VISIT DATE: 06/08/2021

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LPA and LPM discussed the following: 100% supervision is required at all times; personal rights; inspection authority; reporting requirements; staff to children ratios and capacity; staff qualifications; and maintaining buildings and grounds. LPA and LPM discussed with Applicant 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.

This facility evaluation report was reviewed and discussed with Applicant. Applicant was encouraged to the visit the Department's website at WWW.CDSS.CA.GOV for information regarding child care updates, forms, regulations and legislation pertaining to child care centers.

The following items are required before a license will be issued:

1. Licensing Program Manager’s final file review.

2. Waiver request for shared outdoor space

3. Photos/proof of equipment, toys and cribs

4. Photos of room set up

5. Finances

6. Partition for courtyard

7. Postings

8. Updated fire clearance

Exit interview conducted.

SUPERVISOR'S NAME: Roxana Saravia	TELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Mai Lor	TELEPHONE: (916) 491-0182
LICENSING EVALUATOR SIGNATURE:	DATE: 06/08/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/08/2021

LIC809 (FAS) - (06/04)

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