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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393622103
Report Date: 02/25/2020
Date Signed: 02/25/2020 01:39:23 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:TEAM CHARTER BIANCHI PRESCHOOLFACILITY NUMBER:
393622103
ADMINISTRATOR:ZAMANI-AHMAD, NURSABAFACILITY TYPE:
850
ADDRESS:1016 EAST BIANCHI ROADTELEPHONE:
(209) 941-9100
CITY:STOCKTONSTATE: CAZIP CODE:
95210
CAPACITY:24CENSUS: 21DATE:
02/25/2020
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
09:40 AM
MET WITH:Susie StevensTIME COMPLETED:
02:30 PM
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At 9:40am Licensing Program Analysts (LPAs) Aruna Sridharan and Gagandeep Singh met with Site Supervisor Susie Stevens in room #22 for random annual inspection. The purpose of the inspection was explained. LPAs toured the facility with site supervisor. Today's census was 21 children with 4 staff members. The facility operates from 6:30am to 6:00pm Monday through Friday. LPAs observed appropriate ratios, care and supervision, and capacity during the visit. The facility provides am/pm snacks and lunch which is prepared in the kitchen. The Program Director arrived at the facility at 10:20am.

LPa's observed that all required postings were posted. Sign In/Out sheet was checked and had proper signatures of parent/guardian. The facility has fire extinguisher next to the entrance door. The facility has age appropriate furniture and toys which are in good repair. The floors are clean and free of hazards. All the chemicals and medication are locked in a cabinet. Facilities has sufficient amount of sleeping mats and cubbies for children. Drinking water is readily available to children inside and outside(water fountains). Toileting facilities were in operating, safe, and sanitary condition. Play yard is free of hazards, play strucuture is age appropriate and in good repair. There are wood chips under play structure to prevent any fall injuries. The facility conducts fire drills atleast once in six months. LPA observed documentation of last fire drill on 01/17/2020.

LPA reviewed 8 children’s files and observed that each child had their Identification/Emergency Information and the Consent for Medical Treatment form filled out and signed by their authorized representative. LPA reviewed all 4 and Directyor files were reviewed.

Report continues on 809C page......
SUPERVISOR'S NAME: Sharon OgbodoTELEPHONE: (916) 263-5721
LICENSING EVALUATOR NAME: Aruna SridharanTELEPHONE: (916) 917-9273
LICENSING EVALUATOR SIGNATURE:

DATE: 02/25/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/25/2020
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 4
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: TEAM CHARTER BIANCHI PRESCHOOL
FACILITY NUMBER: 393622103
VISIT DATE: 02/25/2020
NARRATIVE
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At least one staff member present today had current Pediatric CPR and First Aid certification (expires 09//20). All staff currently employed with the facility have proof of immunizations. LPA also reviewed documentation of qualifications including education and experience. All staff members have mandated reporter training AB1207 completed.

LPA also discussed Unusual Incident Reports (UIRs) and reporting requirements. LPA informed the Director that if any unusual incidents occur she must contact the Department within 24 hours and an UIR must be submitted with 7 day, describing the specifics to the incident.

LPA provided the Community Care Licensing’s website www.ccld.ca.gov, so the licensee can obtain updated licensing information, new regulations and access forms. LPA advised the licensee of their responsibility to stay current in regards to new regulations.

LPA discussed the Incidental Medical Services (IMS) policies with the licensee. The facility is currently providing IMS; however, LPA discussed the IMS policy. For IMS information see the Evaluator Manual Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and Medication Regulations 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), 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: www.ada.gov/childqanda.

Title 22 Deficiencies observed in the areas that were evaluated are on 809D and Civil penalties were assessed. The center is informed to provide a copy of the evaluation report and type 'A' violation to the parents and guardians of the children currently enrolled in care and to parents of newly enrolled children during next 12 months. A signed and dated LIC 9224 Form shall be maintained in all children's files. LPA reviewed report and provided copies to the facility. An exit interview was conducted. Appeal Rights were provided and Notice of Site Visit posted and the director understands it must remain posted for 30 days.

SUPERVISOR'S NAME: Sharon OgbodoTELEPHONE: (916) 263-5721
LICENSING EVALUATOR NAME: Aruna SridharanTELEPHONE: (916) 917-9273
LICENSING EVALUATOR SIGNATURE:

DATE: 02/25/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/25/2020
LIC809 (FAS) - (06/04)
Page: 2 of 4
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: TEAM CHARTER BIANCHI PRESCHOOL
FACILITY NUMBER: 393622103
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/25/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/26/2020
Section Cited

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101170(e)(2) - Criminal Record Clearance : All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility:
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 Request a transfer of a criminal record clearance as specified in Section 101170(f). This requirement is not met as evidenced by during record review, it was found that the facility did not associated the criminal background clearance of all five present staff with this facility. This poses an immediate health and safety risk to children in care. Civil penalties are assesed.
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Type A
02/26/2020
Section Cited

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1596.954 - Carbon monoxide detectors required; inspection :
Every licensed child day care center shall have one or more carbon monoxide detectors in the facility that meet the standards established in
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Chapter 8 (commencing with Section 13260) of Part 2 of Division 12. This requirement is not met as evidenced by during LPAs inspection, no carbon monoxide detector was observed in the facility. This poses potential health and safety risk to 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: Sharon OgbodoTELEPHONE: (916) 263-5721
LICENSING EVALUATOR NAME: Aruna SridharanTELEPHONE: (916) 917-9273
LICENSING EVALUATOR SIGNATURE:
DATE: 02/25/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/25/2020
LIC809 (FAS) - (06/04)
Page: 3 of 4
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: TEAM CHARTER BIANCHI PRESCHOOL
FACILITY NUMBER: 393622103
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/25/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/13/2020
Section Cited

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1596.798 (a)(1) : Child day care facility staff administration of inhaled medication; requirements
The licensee or staff person has been provided with written authorization from the minor's parent or legal guardian.....
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to administer inhaled medication and authorization to contact the child's health care provider. This requirement is not met as evidenced by during record review, LPAs did not observed the medical consent form from the parent or guardian for a child who use inhaler medication. This poses potential health and safety risk to 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: Sharon OgbodoTELEPHONE: (916) 263-5721
LICENSING EVALUATOR NAME: Aruna SridharanTELEPHONE: (916) 917-9273
LICENSING EVALUATOR SIGNATURE:
DATE: 02/25/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/25/2020
LIC809 (FAS) - (06/04)
Page: 4 of 4