343624134-1-21-2022-03-CC-MLOR-CAVR8K-20220121114803

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343624134
Report Date: 01/21/2022
Date Signed: 01/21/2022 11:48:14 AM

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:	LRCCD SCC CHILD DEVELOPMENT CENTER		FACILITY NUMBER:	343624134
ADMINISTRATOR:	SADAT ZAREK		FACILITY TYPE:	830
ADDRESS:	3835 FREEPORT BLVD		TELEPHONE:	(916) 650-2757
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95822
CAPACITY:	20	CENSUS: 0	DATE:	01/21/2022
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Laurie Perry and Sadat Zarek		TIME COMPLETED:	12:00 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	Application Specialist (AS) Mai Lor and Licensing Program Analyst (LPA) Christopher Bello met with Applicant Laurie Perry and Site Director Sadat Zarek for the purpose of an announced pre-licensing inspection. Applicant request an infant license to serve 16 infant children from age birth to 24. The program will operate Monday through Friday from 7:30 a.m. to 5:00 p.m. The fire clearance was granted on 12/15/2021. Applicant acknowledges that the following documents must be posted at all times: License, Emergency Disaster Plan, Personal Rights, Parents' Rights Poster, car seat poster, menus, and daily schedule. The facility will provide morning and afternoon snacks for children who are on solid food. Parents will provide formula and milk. INDOOR ACTIVITY SPACE: There is one classroom and a separate napping room for infants and toddlers. AS and LPA observed sufficient amount of equipment, toys, tables, chairs, toddler tables, cubbies, napping cots, and three cribs. Applicant acknowledges there will be a maximum of three infants under 12 months old, due to available cribs. There is a first aid kit in the classroom and in the first aid room. Medications will be stored in the first aid room. AS and LPA observed cleaning disinfectants appropriately stored and inaccessible to children. Applicant stated there are no poisons or firearms on the premises. Applicant stated tap water will be provided through a water pitcher. Facility will provide disposable cups, sippy cups or plastic cups for all children. AS and LPA observed a paper sign-in/sign-out system. AS and LPA observed a carbon monoxide detector in the lobby. (Report continues on subsequent LIC 809).

SUPERVISOR'S NAME: Roxana Saravia	TELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Mai Lor	TELEPHONE: (916) 491-0182
LICENSING EVALUATOR SIGNATURE:	DATE: 01/21/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2022

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: LRCCD SCC CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 343624134
	VISIT DATE: 01/21/2022

NARRATIVE

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AS measured the classroom. The total classroom space contains a total of 1332.806 square feet, which will accommodate Licensee’s request for 16 infants. There are two toilets and seven sinks for the children, and a separate private restroom for the staff. AS and LPA observed two changing tables 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 first aid room and will use the staff restroom, if necessary.

OUTDOOR ACTIVITY SPACE:
There is one outdoor area on the property with an extra yard for bikes. The outdoor play area is fenced with a chain that is at least four feet tall. AS and LPA observed sufficient amount of equipment and toys. There are no bodies of water on the premises. There are shaded areas supplied by trees and overhangs.

AS Lor measured the outdoor activity space. The outdoor play area contains a total of 5035.404 square feet, which will accommodate Applicant's request for 16 infant children. Individual measurements are recorded on the Capacity Worksheet (LIC 9024).

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.

(Report continues on subsequent LIC 809).

SUPERVISOR'S NAME: Roxana Saravia	TELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Mai Lor	TELEPHONE: (916) 491-0182
LICENSING EVALUATOR SIGNATURE:	DATE: 01/21/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2022

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: LRCCD SCC CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 343624134
	VISIT DATE: 01/21/2022

NARRATIVE

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AS discussed the following: 100% supervision is required at all times, including in the bathroom; 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.

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.

LPA discussed the safe sleep regulations with licensee 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 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.

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.

Prior to issuing a license, the following items must be corrected:

1. Pending Licensing Program Manager Roxana Saravia's final review

Exit interview conducted and report was reviewed with the Applicant Laurie Perry and Site Director Sadat Zarek.

SUPERVISOR'S NAME: Roxana Saravia	TELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Mai Lor	TELEPHONE: (916) 491-0182
LICENSING EVALUATOR SIGNATURE:	DATE: 01/21/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2022

LIC809 (FAS) - (06/04)

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