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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343624004
Report Date: 11/10/2021
Date Signed: 11/10/2021 01:41:02 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:MOREY AVENUE EARLY LEARNING CENTERFACILITY NUMBER:
343624004
ADMINISTRATOR:THOMPSON, TABITHAFACILITY TYPE:
830
ADDRESS:155 MOREY AVENUETELEPHONE:
(916) 566-3485
CITY:SACRAMENTOSTATE: CAZIP CODE:
95838
CAPACITY:24CENSUS: DATE:
11/10/2021
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Tabitha ThompsonTIME COMPLETED:
01:45 PM
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Application Specialist (AS) Mai Lor and Licensing Program Analyst (LPA) Alize Tillery met with Applicant Tabitha Thompson for the purpose of an announced pre-licensing inspection. Applicant request an infant license to serve 8 infants from 12 months to 24 months and 8 toddlers from age 18 months to 36 months under a Toddler Option Program. The facility operates in adjoining portable classroom #10A and #10B. The program will operate Monday through Friday from 8:00 AM to 2:30 PM. The fire clearance was granted on 09/15/21.

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. AS and LPA 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. Applicant stated parents will provide all formula, milk, and food for children under 1 and the program will provide provide breakfast, lunch and pm snacks for older infants.

INDOOR ACTIVITY SPACE:
There is one infant classroom in an adjoining portable classroom: Classroom #10A and #10B. AS and LPA observed a sufficient number of tables, chairs, and cubbies for infants and toddlers. Infant and toddler activity space is separated by a wall that is at less than four feet tall. Applicant stated they will not have a napping area due to the age the applicant will be serving. Applicant will submit a waiver request indicating the above. AS and LPA observed sufficient napping cots/mats. AS and LPA observed a variety of age-appropriate toys and equipment. There is a first aid kit in each of the classrooms. Medications will be stored in the cabinets and inaccessible to children. AS and LPA observed cleaning disinfectants are appropriately stored and inaccessible to children.

(Report continues on subsequent LIC 809)
SUPERVISOR'S NAME: Roxana SaraviaTELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Mai LorTELEPHONE: (916) 491-0182
LICENSING EVALUATOR SIGNATURE:

DATE: 11/10/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/10/2021
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 4
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: MOREY AVENUE EARLY LEARNING CENTER
FACILITY NUMBER: 343624004
VISIT DATE: 11/10/2021
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 Applicant stated there are no poisons or firearms on the premises. Applicant stated drinking water for indoor and outdoor will be provided via water pitcher. AS and LPA observed a functional carbon monoxide detector each of the classrooms. AS and LPA observed an electronic sign-in/sign-out system.

AS and LPA measured the classroom. The total classroom space contains a total of 1606.689 square feet, which will accommodate Applicant's requested capacity for 8 infant children and 8 toddlers under the toddler option program. There are 20 toilets and 22 sinks available to children, and a separate staff restroom is available. Individual measurements are recorded on the Capacity Worksheet (LIC 9024). AS and LPA observed two changing tables with a changing pad that is at least one inch think with raised sides that are at least three inches tall. 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 designated for infants and toddlers under the toddler option program. The outdoor space will be shared with the infants and toddlers on a rotation schedule. A waiver was previously submitted. The outdoor play area is fenced with a chain link fence that is at last four feet tall. AS and LPA observed a variety of age-appropriate outdoor toys and equipment. There is a play structure that is designated for children ages 2 to 5. Applicant was reminded to follow the safety label and staff will provide supervision to ensure children under the age of 2 will not be using the play structure. AS and LPA observed poured-in-place rubber surfacing used as cushion. The playground is shaded by a shade structure.

AS and LPA measured the outdoor activity space. The outdoor play area contains a total of 2730.774 square feet, which will accommodate the applicant's requested capacity of 8 infants and 8 toddlers under the Toddler Option Program.

AS 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. AS 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.

(Report continues on subsequent LIC 809)

SUPERVISOR'S NAME: Roxana SaraviaTELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Mai LorTELEPHONE: (916) 491-0182
LICENSING EVALUATOR SIGNATURE:

DATE: 11/10/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/10/2021
LIC809 (FAS) - (06/04)
Page: 2 of 4
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: MOREY AVENUE EARLY LEARNING CENTER
FACILITY NUMBER: 343624004
VISIT DATE: 11/10/2021
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Prior to this inspection, AS emailed Effects of Lead Exposure brochure and Provider Notice Information (PIN) 21-21 (Release of the Written Directives for Lead Testing of Water in Licensed Child Care Centers per AB 2370). AS and LPA reviewed lead testing requirement and COVID-19 technical assistance with the applicant.

This facility plans to provide Incidental Medical Services - IMS. For IMS information, see Evaluator Manuel - Regulation Interpretations and Procedures for Child Care Centers Section 101173 and 101226. A 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.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage athttps://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee 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.


Licensee 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.

Licensee was encouraged to visit the Department website at WWW.CCLD.CA.GOV for child care updates, current forms, legislation and regulation information. A copy of this report will remain on file for a period of three years for public review upon request.

(Report continues on subsequent LIC 809)
SUPERVISOR'S NAME: Roxana SaraviaTELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Mai LorTELEPHONE: (916) 491-0182
LICENSING EVALUATOR SIGNATURE:

DATE: 11/10/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/10/2021
LIC809 (FAS) - (06/04)
Page: 3 of 4
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: MOREY AVENUE EARLY LEARNING CENTER
FACILITY NUMBER: 343624004
VISIT DATE: 11/10/2021
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Prior to licensure, the following items must be corrected:

1. Updated parent handbook and admission agreement to reflect the age group that the facility will be servicing.
2. Submit waiver for napping area
3. Updated list of furniture and equipment
4. Director Verification documents to include infant units, mandated reporter training, preventative health and safety training.
5. Licensing Program Manager's final review
6. Dividers that is at least 4 feet tall to physically separate infants from toddlers.
7. Revised fire clearance

Exit interview conducted and report was reviewed with the Applicant, Tabitha Thompson.

SUPERVISOR'S NAME: Roxana SaraviaTELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Mai LorTELEPHONE: (916) 491-0182
LICENSING EVALUATOR SIGNATURE:

DATE: 11/10/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/10/2021
LIC809 (FAS) - (06/04)
Page: 4 of 4