<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 344500390
Report Date: 04/29/2021
Date Signed: 04/29/2021 11:25:37 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:FRANKLIN ELEMENTARY SCHOOLFACILITY NUMBER:
344500390
ADMINISTRATOR:DIANE DAVIS-QUIDGEONFACILITY TYPE:
850
ADDRESS:5401 DORCEY DRIVETELEPHONE:
(916) 684-6518
CITY:ELK GROVESTATE: CAZIP CODE:
95757
CAPACITY:24CENSUS: 0DATE:
04/29/2021
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Mikako FisherTIME COMPLETED:
11:30 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 Specialist (AS) Alecia Sifuentes and Licensing Program Analyst (LPA) Fabiola Diaz met with Program Specialist, Mikako Fisher for the purpose of an announced pre-licensing change of location tele-inspection via FaceTime due to COVID-19. Applicant requests a preschool license to serve 24 preschool children from age three to entry into first grade. The program will operate Monday through Friday from 7:30 a.m. to 3:30 p.m. The fire clearance was granted and received on 4/12/2021.

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 snack, lunch, and afternoon snack.

INDOOR ACTIVITY SPACE:
There is one preschool classroom. AS observed a sufficient amount of equipment, toys, tables, chairs, and cubbies. There is a first aid kit in the classroom. Medications will be stored in the classroom above the fridge. AS observed cleaning disinfectants are appropriately stored and inaccessible to children. Applicant stated there are no poisons or firearms on the premises. AS observed water pitchers and cups in the classroom. AS observed a functional dual smoke and carbon monoxide detector in the classroom. AS observed sign-in/sign-out binders.

Report continues on 809-C.
SUPERVISOR'S NAME: Jeanne SmithTELEPHONE: (916) 208-4405
LICENSING EVALUATOR NAME: Alecia SifuentesTELEPHONE: (916) 917-9202
LICENSING EVALUATOR SIGNATURE:

DATE: 04/29/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2021
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 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: FRANKLIN ELEMENTARY SCHOOL
FACILITY NUMBER: 344500390
VISIT DATE: 04/29/2021
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
26
27
28
29
30
31
32
AS measured one classroom. The total classroom space contains a total of 975.14 square feet, which will accommodate Applicant's request for 24 preschool children. There are 2 toilets and 2 sinks for the children, and a separate private restroom for the staff. There is a Shared Bathroom Waiver on file. 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. The outdoor play area is fenced with a chain link fence that is at least four feet tall. AS observed a sufficient amount of equipment and toys. The play structure includes a safety label, which designates use for children 2 to 5 years old. There are no bodies of water on the premises. There are shaded areas supplied by trees and overhangs. The outdoor play area is shared with the elementary school children at separate times of the day. Applicant has requested a Shared Playground Waiver.

AS measured the outdoor activity space. The outdoor play area contains a total of 7740 square feet, which will accommodate Applicant's request for 24 preschool children. Individual measurements are recorded on the Capacity Worksheet (LIC 9024).

The facility's Incidental Medical Services and a Plan of Operation is located in the facility file. 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: Jeanne SmithTELEPHONE: (916) 208-4405
LICENSING EVALUATOR NAME: Alecia SifuentesTELEPHONE: (916) 917-9202
LICENSING EVALUATOR SIGNATURE:

DATE: 04/29/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2021
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: FRANKLIN ELEMENTARY SCHOOL
FACILITY NUMBER: 344500390
VISIT DATE: 04/29/2021
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
26
27
28
29
30
31
32
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.

This facility evaluation report was discussed and emailed to the 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.

Effective today, 4/29/2021, AS will approve the facility licensed to serve 24 children from age 3 years to entry into first grade.
SUPERVISOR'S NAME: Jeanne SmithTELEPHONE: (916) 208-4405
LICENSING EVALUATOR NAME: Alecia SifuentesTELEPHONE: (916) 917-9202
LICENSING EVALUATOR SIGNATURE:

DATE: 04/29/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2021
LIC809 (FAS) - (06/04)
Page: 3 of 3