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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393621826
Report Date: 02/20/2025
Date Signed: 02/20/2025 01:45:47 PM

Document Has Been Signed on 02/20/2025 01:45 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:SEQUOIA CHRISTIAN PRESCHOOLFACILITY NUMBER:
393621826
ADMINISTRATOR/
DIRECTOR:		CARMEN BAUGHFACILITY TYPE:
850
ADDRESS:1050 SOUTH UNION ROADTELEPHONE:
(209) 815-9341
CITY:MANTECASTATE: CAZIP CODE:
95337
CAPACITY: 90TOTAL ENROLLED CHILDREN: 90CENSUS: 46DATE:
02/20/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:45 PM
MET WITH:Carmen BaughTIME VISIT/
INSPECTION COMPLETED:
02:15 PM
NARRATIVE
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On February 20th, 2025, at 12:45 pm, Licensing Program Analysts (LPAs) Lauren Scott and Janie Davis met with Director, Carmen Baugh to follow up on an Unusual Incident Report (UIR) that was reported to Community Care Licensing on 02/19/2024.


The facility reported the UIR to Community Care Licensing within 24hrs. Facility was reminded to submit a written UIR within 7 days.

LPAs toured the facility and observed forty-six (46) children being supervised by three (3) adult teachers. LPAs learned an additional staff was inside with 5 children, leaving three staff with the remaining 41 children. LPAs determined through observation and review, D1 did not ensure ratios were met, as well as playground safety regulations were adhered to, which poses an immediate health, safety or personal rights risk to persons in care.

Through review of records and observation, LPAs learned children under the age of 5 were being allowed on play structure as well. This also poses an immediate health, safety or personal rights risk to persons in care.

Two Type A violations were assessed on a subsequent 809-D page. An exit interview was conducted, and the report was reviewed with D1. Licensee Appeal Rights were provided to D1. A Notice of Site visit was posted by LPA and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

LPAs informed director, Carmen Baugh, that this report dated 02/20/2025 documents two Type A citations which shall be posted for 30 consecutive days as there is an immediate risk to the health, safety, or personal rights of children in care.

REPORT CONTINUES ON 809-C

SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: Janie Davis
LICENSING EVALUATOR SIGNATURE: DATE: 02/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/20/2025
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
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: SEQUOIA CHRISTIAN PRESCHOOL
FACILITY NUMBER: 393621826
VISIT DATE: 02/20/2025
NARRATIVE
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Also, LPAs informed the facility representative to provide a copy of this licensing report dated, 2/20/2025, that documents any Type A citations to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.
SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: Janie Davis
LICENSING EVALUATOR SIGNATURE:

DATE: 02/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/20/2025
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 02/20/2025 01:45 PM - It Cannot Be Edited


Created By: Janie Davis On 02/20/2025 at 01:19 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: SEQUOIA CHRISTIAN PRESCHOOL
FACILITY NUMBER: 393621826

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/20/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/21/2025
Section Cited
CCR
101223(a)(2)

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(a) The licensee shall ensure that each child is accorded the following personal rights:
(2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs.
This requirement was not met as evidenced by...
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Facility will conduct a staff meeting discussing proper use of play structure based on manufacturers regulations. Facility will submit signed meeting notes to CCLD by POC date
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Based on record review and observation LPAs learned children under the age of 5 were being allowed on play structure.
This is an immediate risk to the health, safety, or personal rights of children in care.
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Type A
02/21/2025
Section Cited
CCR101216.3(a)

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(a) There shall be a ratio of one teacher visually observing and supervising no more than 12 children in attendance...

This requirement was not met as evidenced by...
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Facility will conduct a staff meeting discussing ratios and how to maintain a ratio of 1:12 at all times, including use of bathroom. Facility will submit signed meeting notes to CCLD by POC date.
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Based observation LPAs counted 41 children being supervised by 3 adults. This is an immediate risk to the health, safety, or 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:Chayntel Hunter
LICENSING EVALUATOR NAME:Janie Davis
LICENSING EVALUATOR SIGNATURE:
DATE: 02/20/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/20/2025


LIC809 (FAS) - (06/04)
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