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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 570311582
Report Date: 10/01/2024
Date Signed: 10/01/2024 03:10:50 PM


Document Has Been Signed on 10/01/2024 03:10 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: 7DATE:
10/01/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Sarah TibbettTIME COMPLETED:
03:25 PM
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Licensing Program Analyst (LPA) Jennie Tedlos met with Director, Sarah Tibbett for the purpose of an unannounced annual inspection. There were XXXX children present during today's inspection. Facility days and hours of operation are Monday-Friday from 8:00 AM to 5:00 PM. LPA reviewed the sign in/out App and observed that the children are properly signed in.

LPA toured the facility inside and out. LPA observed that hazardous items (disinfectants, cleaning solutions etc.) were inaccessible to children in care. LPA reviewed care and supervision of children, staffing ratios, medications and first aid supplies, furniture, equipment, fire drills and drinking water. 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 appeared to be in good repair, there is sufficient cushioning under the play structure to prevent the fall. LPA observed all required forms to be posted. There are needs and services plans for each infant enrolled. LPA observed proper storage of refrigerated bottles which were dated and labeled with children's names.

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.

The Director 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. REPORT CONTINUED ON SUBSEQUENT PAGE, 809 C
SUPERVISOR'S NAME: Karyn GuerraTELEPHONE: (916) 216-7790
LICENSING EVALUATOR NAME: Jennie TedlosTELEPHONE: (916) 936-7763
LICENSING EVALUATOR SIGNATURE:
DATE: 10/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/01/2024
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: 10/01/2024
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LPA discussed the safe sleep regulations with 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 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.

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/.

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 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 verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

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.

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.



Exit interview conducted and report was reviewed with the Director, Sarah Tibbett. A notice of site visit was given and must remain posted for 30 days. In the areas that were evaluated, no deficiencies were cited during the inspection.
SUPERVISOR'S NAME: Karyn GuerraTELEPHONE: (916) 216-7790
LICENSING EVALUATOR NAME: Jennie TedlosTELEPHONE: (916) 936-7763
LICENSING EVALUATOR SIGNATURE:

DATE: 10/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/01/2024
LIC809 (FAS) - (06/04)
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