343624192-3-2-2022-03-CC-MLOR-CC5P36-20220302095700

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343624192
Report Date: 03/02/2022
Date Signed: 03/02/2022 09:57:13 AM

Document Has Been Signed on 03/02/2022 09:57 AM - 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:	SINGLE MOM STRONG - EMPOWERME PRESCHOOL CHILDCARE		FACILITY NUMBER:	343624192
ADMINISTRATOR:	TERRELL, LE TAUNYA		FACILITY TYPE:	850
ADDRESS:	500 ARDEN WAY		TELEPHONE:	(916) 687-1282
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95815
CAPACITY: 30	TOTAL ENROLLED CHILDREN: 30	CENSUS: 0	DATE:	03/02/2022
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Tara Taylor and Le Taunye Terrell		TIME COMPLETED:	10:15 AM

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 Specialists (AS) Mai Lor and Alecia Sifuentes met with Applicant Tara and Site Director Le Taunye Terrell for the purpose of an announced pre-licensing inspection. Applicant request a preschool license to serve 30 preschool children from age two to entry into first grade. The program will operate Monday through Friday from 7:00 AM to 6:00 PM. The fire clearance was granted on 01/28/2022. AS reviewed with applicant the LIC 311A, Records To Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted. 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. The facility will provide AM/PM snacks and parents are responsible for lunch. INDOOR ACTIVITY SPACE: There is one classroom. AS observed sufficient amount of age-appropriate equipment, toys, tables, and cubbies. There is a kitchen to support the food service equipped with a stove and refrigerator. There is a first aid kit in the office. Applicant stated medications will stored in the office. Applicant stated there are no firearms or weapon on the premises. Applicant stated indoor and outdoor drinking water is provided via water dispenser with individualized water bottles. AS observed a carbon monoxide detector in the facility. AS observed a paper sign-in/sign-out system. (Report continued on subsequent LIC 809)

SUPERVISORS NAME: Roxana Saravia
LICENSING EVALUATOR NAME: Mai Lor
LICENSING EVALUATOR SIGNATURE:	DATE: 03/02/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2022

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: SINGLE MOM STRONG - EMPOWERME PRESCHOOL CHILDCARE	FACILITY NUMBER: 343624192
	VISIT DATE: 03/02/2022

NARRATIVE

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AS measured the classroom. The total classroom space contains a total of 1733.50 square feet, which will accommodate the requested capacity for 30 preschool children. There are two toilets and two sinks available for children. There is a separate private restroom for the staff. Children who become ill during the day will be isolated in the office and will use the staff restroom, if necessary. Individual measurements are recorded on the Capacity Worksheet (LIC 9024).

OUTDOOR ACTIVITY SPACE:

There is an outdoor activity space for preschool. The outdoor play area is surrounded by a fence that is at least four feet tall. AS observed no play structure. Applicant was reminded that children are to use age appropriate toys and equipment. AS observed sufficient amount of age-appropriate equipment and toys. There are shaded areas supplied by trees and overhangs.

AS measured the outdoor space. The outdoor play area contains a total of 1526.31 square feet, which will not accommodate Applicant's request for 30 preschool children. The maximum outdoor space can accommodate 20 children. Applicant is to submit an insufficient outdoor waiver request with an updated daily schedule for outdoor times. Individual measurements are recorded on the Capacity Worksheet (LIC 9024).

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.

This facility plans to provide Incidental Medical Services – IMS. For IMS information, see PIN 22-02-CCP. 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 continued on subsequent LIC 809)

SUPERVISORS NAME: Roxana Saravia
LICENSING EVALUATOR NAME: Mai Lor
LICENSING EVALUATOR SIGNATURE:	DATE: 03/02/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2022

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: SINGLE MOM STRONG - EMPOWERME PRESCHOOL CHILDCARE	FACILITY NUMBER: 343624192
	VISIT DATE: 03/02/2022

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Applicant 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.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.

To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

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

1. Submit insufficient outdoor waiver request

2. Pending Licensing Program Manager Seychelle De Luca’s final review

Exit interview conducted and report was reviewed with Applicant, Tara Taylor, and Site Director Le Taunye Terrell.

SUPERVISORS NAME: Roxana Saravia
LICENSING EVALUATOR NAME: Mai Lor
LICENSING EVALUATOR SIGNATURE:	DATE: 03/02/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2022

LIC809 (FAS) - (06/04)

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