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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073408236
Report Date: 11/29/2021
Date Signed: 12/09/2021 10:37:21 AM

Document Has Been Signed on 12/09/2021 10:37 AM - 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, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:LITTLE ROSES PRESCHOOLFACILITY NUMBER:
073408236
ADMINISTRATOR:TAMMY DEMPSEYFACILITY TYPE:
850
ADDRESS:1180 STARR STTELEPHONE:
(510) 787-1112
CITY:CROCKETTSTATE: CAZIP CODE:
94525
CAPACITY: 22TOTAL ENROLLED CHILDREN: 22CENSUS: DATE:
11/29/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Heather PosnerTIME COMPLETED:
04:00 PM
NARRATIVE
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On November 29, 2021 at 1:30pm. Licensing Program Analysts (LPAs) Ashley Curry and Monica Mathur conducted an unannounced Case Management inspection at Little Roses Preschool. LPAs met with the director, Heather Posner and explained the purpose of today's inspection. The facility self reported an unusual incident where a child (C1) broke away from the group and ran across the parking lot onto the sidewalk and crossed the street. Staff retrieved the child after the child had crossed the street. In another incident C1 ran out of the gate and into the parking lot while parents were arriving for pick up before being retrieved by staff. Although staff had visual of the child in both incidents, there was neglect due to the child crossing the street and going off grounds, which resulted in an immediate risk to the health and safety of the child. Type A deficiency is cited for neglect.

Exit interview was conducted with Heather Posner and report was discussed. A Notice of Site Visit was issued and must be posted for 30 Days

Due to the issuance of Type A citation, a copy of this report has to be provided to all existing parents and those newly enrolled over the next 12 months. Statement Acknowledging Receipt of Licensing Reports LIC9224 should be signed by parent and kept in each child's file. This report is required to be posted in public view for 30 days.

This is an amended report.
SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Ashley Curry
LICENSING EVALUATOR SIGNATURE: DATE: 11/29/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/29/2021
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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Document Has Been Signed on 12/01/2021 04:08 PM - It Cannot Be Edited


Created By: Ashley Curry On 11/29/2021 at 02:47 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
, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: LITTLE ROSES PRESCHOOL
FACILITY NUMBER: 073408236

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/29/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/30/2021
Section Cited
CCR
101229(a)(1)

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101229(a) The licensee shall provide care and supervision as necessary to meet the children's needs. (1) No child(ren) shall be left without the supervision of a teacher at any time Supervision shall include visual observation. This requirement is not met as evidence by:
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By the end of the day on 11/30/2021 submit a written plan to Licensing regarding an indivualized plan of supervision for C1.

By 12/8/2021 conduct an all staff training to discuss supervison. Watch video on www.ccld.ca.gov and submit proof of training.


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Per LPA's investigation C1 ran across the parking lot and street. In the second incident C1 ran out of the gate and into the parking lot while parents were arriving for pickup. Staff had visual on C1 both times. This is an immediate risk to the health and safety of the child.
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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:Loretta Dyson
LICENSING EVALUATOR NAME:Ashley Curry
LICENSING EVALUATOR SIGNATURE:
DATE: 11/29/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/29/2021


LIC809 (FAS) - (06/04)
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