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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393616060
Report Date: 08/02/2022
Date Signed: 08/02/2022 12:37:57 PM


Document Has Been Signed on 08/02/2022 12:37 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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833



FACILITY NAME:ZION CHILD CARE CENTERFACILITY NUMBER:
393616060
ADMINISTRATOR:SAWYER, JENNIFERFACILITY TYPE:
830
ADDRESS:105 SOUTH HAM LANETELEPHONE:
(209) 369-1919
CITY:LODISTATE: CAZIP CODE:
95242
CAPACITY:36CENSUS: 20DATE:
08/02/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Jennifer SawyerTIME COMPLETED:
12:50 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
On August 2, 2022, Licensing Program Analyst (LPA) Salene Mayberry met with Director Jennifer Sawyer for the purpose of an unannounced case management visit. Census included 20 children supervised by seven staff members and one volunteer.

On May 18, 2022, LPA was touring the facility and noticed signs posted outside of the classrooms titled “Zion Child Care & Preschool Exposure Notice”. The notices indicated that on May 5 and 13, 2022, children may have been exposed to the following highly contagious virus: Hand Foot and Mouth disease. A review of the Community Care Licensing (CCL) file revealed that the facility had failed to notify licensing. LPA discussed Reporting Requirements, Section 101212 with Director during the visit and provided her with a copy of the regulations.

A Type B deficiency was cited on the subsequent page (LIC809-D) of this report.

An Exit interview was conducted, and the report was reviewed and discussed with Director. Appeal Rights and a copy of the report was printed and provided to the Director. 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.
SUPERVISOR'S NAME: Bettina EngelmanTELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Salene MayberryTELEPHONE: 916-263-5744
LICENSING EVALUATOR SIGNATURE:
DATE: 08/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/02/2022
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 2


Document Has Been Signed on 08/02/2022 12:37 PM - It Cannot Be Edited

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: ZION CHILD CARE CENTER
FACILITY NUMBER: 393616060

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/02/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/05/2022
Section Cited

1
2
3
4
5
6
7
101212 Reporting Requirements(d) Upon the occurrence, during the operation of the child care center of any of the events specified in (d)(1) below, a report shall be made to the Department…(E)Epidemic outbreaks. This requirement was not met as evidenced by:
8
9
10
11
12
13
14
LPA learned there had been an outbreak of Hand Foot and Mouth disease at the facility that was not reported to Licensing. This poses a potential Health and Safety risk to children in care.
8
9
10
11
12
13
14

1
2
3
4
5
6
7

1
2
3
4
5
6
7
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 EngelmanTELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Salene MayberryTELEPHONE: 916-263-5744
LICENSING EVALUATOR SIGNATURE:
DATE: 08/02/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/02/2022
LIC809 (FAS) - (06/04)
Page: 2 of 2