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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 093617580
Report Date: 08/19/2021
Date Signed: 08/19/2021 03:11:00 PM

Document Has Been Signed on 08/19/2021 03:11 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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME:PRAISELAND ACADEMY OF EL DORADO HILLS (PS)FACILITY NUMBER:
093617580
ADMINISTRATOR:HESTER, LISA JANELLFACILITY TYPE:
850
ADDRESS:5003 WINDPLAY, SUITE 3TELEPHONE:
(530) 781-3556
CITY:EL DORADO HILLSSTATE: CAZIP CODE:
95762
CAPACITY: 97TOTAL ENROLLED CHILDREN: 0CENSUS: 51DATE:
08/19/2021
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
11:35 AM
MET WITH:Lisa HesterTIME COMPLETED:
03:30 PM
NARRATIVE
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LPA Pascual met with Facility Representative Lisa Hester to discuss a child left unattended. Facility Director stated that during outside play time, a child had climbed up a small dirt hill and hide in the bushes in their play yard and was not visible. When all of the children were brought inside the child was left behind and unattended. The incident happened about on or around August 10th of 2021.

The Facility Director stated that they have now put up some orange plastic fencing to keep children away from climbing the hill and do a head count when bringing children outside to the play yard and again when bringing them inside. Further, a designated person will walk the perimeter of the play yard and check all bushes to ensure no children are hiding.

Due to the child being left unattended for a period of time a citation A and an immediate civil penalty will be assessed.

LPA discussed reporting requirements to licensing as well.
SUPERVISORS NAME: Maria Mayorga
LICENSING EVALUATOR NAME: Michelle Pascual
LICENSING EVALUATOR SIGNATURE: DATE: 08/19/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/19/2021
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 08/19/2021 03:11 PM - It Cannot Be Edited


Created By: Michelle Pascual On 08/19/2021 at 02:48 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
, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: PRAISELAND ACADEMY OF EL DORADO HILLS (PS)
FACILITY NUMBER: 093617580

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/19/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/19/2021
Section Cited
CCR
101229(a)(1)

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The licensee shall provide care and supervision as necessary to meet the children's needs.
No child(ren) shall be left without the supervision of a teacher at any time,
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Facility Director added plastic fencing to keep the children from climbing up a hill and hiding behind bushes.
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This was not evidenced by: LPA speaking to the Facility Director who admitted that the child was left unattended.
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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:Maria Mayorga
LICENSING EVALUATOR NAME:Michelle Pascual
LICENSING EVALUATOR SIGNATURE:
DATE: 08/19/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/19/2021


LIC809 (FAS) - (06/04)
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