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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 570311582
Report Date: 09/28/2023
Date Signed: 09/28/2023 01:31:33 PM


Document Has Been Signed on 09/28/2023 01:31 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:RUSSELL PARK CHILD DEVELOPMENT CENTER (INFANTS)FACILITY NUMBER:
570311582
ADMINISTRATOR:SHELBY FARIAFACILITY TYPE:
830
ADDRESS:400 RUSSELL PARKTELEPHONE:
(530) 753-2487
CITY:DAVISSTATE: CAZIP CODE:
95616
CAPACITY:12CENSUS: DATE:
09/28/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Sarah TibbettTIME COMPLETED:
02:00 PM
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Licensing Program Analyst (LPA) Erwin Tjhia met with the Center Director, Sarah Tibbett for the purpose of an unannounced Annual/Random inspection. There were 6 children present during today's inspection. Facility days and hours of operation are Monday-Friday from 8 AM to 5 PM. There was a waiver on file for Montessori Bed Boxes. The waiver was being followed according to terms.

All staff present during today's inspection have a fingerprint clearance. Director was reminded that all adults 18 and over, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA toured the facility inside and out. LPA observed that hazardous items (disinfectants, cleaning solutions etc.) were inaccessible to children in care. LPA observed proper storage of refrigerated bottles which were dated and labeled with children's names. LPA reviewed care and supervision of children, staffing ratios, medications and first aid supplies, furniture, equipment, fire drills and drinking water. LPA observed all required forms to be posted. There were bed boxes available for each infant under 12 months old. There are needs and services plans for each infant and toddler enrolled.

LPA observed a changing table within arm's reach of the sink. There are adequate toys and equipment available for children. Outdoor play area was toured, the play structure for the infants appeared to be in good repair, there is sufficient cushioning (Sponge) under the play structure to prevent the fall. LPA reviewed the sign in/out book and observed that the children are properly signed in.

Report Continue on 809-C
SUPERVISOR'S NAME: Bettina EngelmanTELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Erwin TjhiaTELEPHONE: 916-263-5744
LICENSING EVALUATOR SIGNATURE:
DATE: 09/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/28/2023
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: RUSSELL PARK CHILD DEVELOPMENT CENTER (INFANTS)
FACILITY NUMBER: 570311582
VISIT DATE: 09/28/2023
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LPA reviewed children’s and staff files. LPA observed health screening reports with TB test and required MMR and TDAP vaccines for all staff members. All staff members present today has current Pediatric CPR and First Aid. LPA observed AB1207 mandated reporter training for all staff. The Director was reminded to renew the course every 2 years through www.mandatedreporterca.com website.

LPA discussed the safe sleep regulations with center director and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed the director of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment. In addition, LPA observed 15min infant napping logs for infants 24 months and under. LPA observed a copy of LIC 9227 Individual Sleeping Plan for infants during today's inspection, per safe sleep regulations.

The facility did not provide Incidental Medical Services (IMS) and the IMS policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 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) 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

Facility director 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.



Exit interview conducted and report was reviewed with the facility Director, Sarah Tibbett. 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.

In the areas that were evaluated, no deficiencies were cited during the inspection
SUPERVISOR'S NAME: Bettina EngelmanTELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Erwin TjhiaTELEPHONE: 916-263-5744
LICENSING EVALUATOR SIGNATURE:

DATE: 09/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2023
LIC809 (FAS) - (06/04)
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