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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393607980
Report Date: 07/31/2024
Date Signed: 07/31/2024 01:51:16 PM

Document Has Been Signed on 07/31/2024 01:51 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:TENDER LOVING CAREFACILITY NUMBER:
393607980
ADMINISTRATOR/
DIRECTOR:		HEATHER M. & PATRICIA V.FACILITY TYPE:
840
ADDRESS:1001 CAMBRIDGE LANETELEPHONE:
(209) 836-8948
CITY:TRACYSTATE: CAZIP CODE:
95377
CAPACITY: 32TOTAL ENROLLED CHILDREN: 22CENSUS: 17DATE:
07/31/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:15 PM
MET WITH:Heather MaloyTIME VISIT/
INSPECTION COMPLETED:
02:15 PM
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On July 31, 2024, Licensing Program Analyst (LPA) Corina Beckby met with Site Director, Heather Maloy, for an unannounced required annual random inspection. Facility days and hours of operation are Monday-Friday from 6:00 AM to 6:00 PM. LPA observed care and supervision of 17 school age children by 2 staff.

LPA inspected all activity and classroom spaces, restrooms, food service, and outdoor play areas. Hazardous items are inaccessible to children. Furniture and equipment are in operable and safe condition. Playground equipment and surfaces are free of loose or sharp parts, and adequate cushioning was observed in areas underneath climbing equipment. 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 in each classroom. Medications are stored in a central location. LPA observed a functional carbon monoxide detector.



The facility serves AM and PM snacks during normal school days. Families provide lunch. LPA observed posted menus showing planned meals at least one week in advance. Noncontaminated Drinking water is readily available to children both indoors and outdoors.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every


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SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Corina Beckby
LICENSING EVALUATOR SIGNATURE: DATE: 07/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/31/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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Document Has Been Signed on 07/31/2024 01:51 PM - It Cannot Be Edited


Created By: Corina Beckby On 07/31/2024 at 01:25 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: TENDER LOVING CARE
FACILITY NUMBER: 393607980

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/31/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in 1 out of 3 Mandated Reporter certificate was missing, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/02/2024
Plan of Correction
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Licensee will email LPA certificate by due date.
Type B
Section Cited
CCR
101216(g)(1)
Personnel Requirements
(1) Except as specified in (3) below, good physical health shall be verified by a health screening, including a test for tuberculosis, performed by or under the supervision of a physician not more than one year prior to or seven days after employment or licensure.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in 1out of 3 physican forms, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/02/2024
Plan of Correction
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Licensee will email physician form by due date.
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:Bettina Engelman
LICENSING EVALUATOR NAME:Corina Beckby
LICENSING EVALUATOR SIGNATURE:
DATE: 07/31/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/31/2024


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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
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: TENDER LOVING CARE
FACILITY NUMBER: 393607980
VISIT DATE: 07/31/2024
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5-years after the date of the first test. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP).

LPA reviewed records for all present staff. At least one staff members present today has current Pediatric CPR and First Aid certification which expires 01/14/25. All staff currently employed with the facility have: a criminal record clearance and documentation of their educational background, training, and/or experience. LPA observed AB1207 Mandated Reporter training certificates for 2 of 3 staff. The Site Director was reminded to renew the course every 2 years through www.mandatedreporterca.com website.

8 children records were reviewed. Each child's file contained a completed emergency contact form, immunization records, signed personal rights form, and a completed medical assessment.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of “medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication. Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process. Continued on LIC 809-C...

SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Corina Beckby
LICENSING EVALUATOR SIGNATURE:

DATE: 07/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/31/2024
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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
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: TENDER LOVING CARE
FACILITY NUMBER: 393607980
VISIT DATE: 07/31/2024
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All individuals subject to criminal record review have obtained clearance. Facility Representative was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Facility Representative was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

During today’s inspection, two type B deficiencies were observed. Exit interview was conducted and report was reviewed with the Site Director, Heather Maloy. A notice of site visit was provided and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. Appeal Rights were provided.

SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Corina Beckby
LICENSING EVALUATOR SIGNATURE:

DATE: 07/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/31/2024
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