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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 390300413
Report Date: 02/21/2020
Date Signed: 02/21/2020 12:54:23 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:LODI DAY NURSERY SCHOOLFACILITY NUMBER:
390300413
ADMINISTRATOR:BECK,CINDYFACILITY TYPE:
850
ADDRESS:760 S HAM LANETELEPHONE:
(209) 334-6884
CITY:LODISTATE: CAZIP CODE:
95242
CAPACITY:135CENSUS: 84DATE:
02/21/2020
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Jan GarrettTIME COMPLETED:
01:15 PM
NARRATIVE
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Licensing Program Analyst (LPA) Justin Denton met with Director Jan Garrett for the purpose of an unannounced annual random inspection. Director was reminded never to exceed the conditions, limitations and capacity specified on the license. Census included 84 preschool children supervised by staff members who all have obtained a criminal record clearance through Community Care Licensing. Facility hours of operation are Monday through Friday from 6:15AM-6:00PM.

LPA toured all activity and classroom spaces, restrooms, food service, and outdoor play areas. Medications are appropriately stored and inaccessible to children. However, at 11:25 AM, LPA observed expired medication for seven children. Director Garrett stated there are no poisons, bodies of water or fire arms on the premises. Toxic and hazardous items are inaccessible to children. Furniture and equipment are in good condition. Playground equipment and surfaces are free of loose or sharp parts. The areas around or under climbing equipment are cushioned with padding to absorb the fall. Toileting facilities are in safe, sanitary and operating condition. The floors appeared clean throughout the facility. The food preparation space is free of litter and all food was protected against contamination. Storage containers with solid waste have tight-fitting covers. Program provides morning snack, afternoon snack and lunch. Menus were posted and drinking water was readily available to children by water fountains located outdoors. LPA observed full legal signatures while reviewing the sign in and sign out sheet.

Three staff and six children's records were reviewed. Each child's file contained an emergency card and a medical assessment. At least one staff member present today has current Pediatric CPR and First Aid certification, which expires on 7/25/2020.
SUPERVISOR'S NAME: Jeanne SmithTELEPHONE: (916) 208-4405
LICENSING EVALUATOR NAME: Justin L DentonTELEPHONE: (916) 926-9269
LICENSING EVALUATOR SIGNATURE:

DATE: 02/21/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2020
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: LODI DAY NURSERY SCHOOL
FACILITY NUMBER: 390300413
VISIT DATE: 02/21/2020
NARRATIVE
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This facility provides Incidental Medical Services- IMS. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing 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.

Title 22 Deficiencies have been cited on the attached LIC 809D. Upon receipt of Type A citations, facility shall post and provide copies of the LIC 809D for parents/guardians of children currently in care and for parents/guardians of newly enrolled children for the next 12 months. Facility must also keep the signed LIC 9224, Acknowledging Receipt of Licensing Reports LIC 809D in each child's files.

An exit interview was conducted and Plans of Corrections (POC) were reviewed and developed with the Licensee. A copy of this report and appeal right were discussed and left with Director Garrett, whose signature on this form confirms receipt of these documents.
SUPERVISOR'S NAME: Jeanne SmithTELEPHONE: (916) 208-4405
LICENSING EVALUATOR NAME: Justin L DentonTELEPHONE: (916) 926-9269
LICENSING EVALUATOR SIGNATURE:

DATE: 02/21/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2020
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: LODI DAY NURSERY SCHOOL
FACILITY NUMBER: 390300413
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/21/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/24/2020
Section Cited

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Health-Related Services: Prescription medications shall be administered in accordance with the label directions as prescribed by the child's physician. This requirement was not met as evidenced by:
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At 11:25AM, LPA observed expired prescription medications for three children. This is an immediate risk to the health, safety, and personal rights of children in care.
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Type A
02/24/2020
Section Cited

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Health-Related Services: Nonprescription medications shall be administered in accordance with the product label directions on the nonprescription medication container(s). This requirement was not met as evidenced by:
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At 11:30AM, LPA observed expired non-prescription medications for six children. This is an immediate risk to the health, safety, and personal rights of children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Jeanne SmithTELEPHONE: (916) 208-4405
LICENSING EVALUATOR NAME: Justin L DentonTELEPHONE: (916) 926-9269
LICENSING EVALUATOR SIGNATURE:
DATE: 02/21/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/21/2020
LIC809 (FAS) - (06/04)
Page: 3 of 3